Organization
COMMUNITY COUNSELING CENTER OF ASHTABULA COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY REGAL MBA (CHIEF EXECUTIVE OFFICER)
(440) 998-4210
Entity
Organization
Contact information
Practice address
2801 C CT, ASHTABULA, OH 44004-4577
(440) 998-4210
(440) 998-6489
Mailing address
2801 C CT, ASHTABULA, OH 44004-4577
(440) 998-4210
(440) 998-6489
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2877329
—
OH
Enumeration date
04/30/2012
Last updated
04/30/2012
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