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Organization

CREEKSIDE COUNSELING CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS RICHARD KUPEC PSY.D, LPCC (DIRECTOR/OWNER)
(330) 533-5450
Entity
Organization

Contact information

Practice address
132 S. BROAD ST. #101, CANFIELD, OH 44406
(330) 533-5450
(330) 533-4292
Mailing address
132 S. BROAD ST. #101, CANFIELD, OH 44406
(330) 533-5450
(330) 533-4292

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
E-0003444-SUPV
OH
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
05/19/2009
Last updated
02/13/2023
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