Organization
COMMUNITY COUNSELING CENTER OF ASHTABULA COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL SAMUEL BOLINO M.S,ED.,LPCC-S, CDCA (CEO)
(440) 998-4210
Entity
Organization
Contact information
Practice address
2801 C CT, ASHTABULA, OH 44004-4577
(440) 998-4210
(440) 998-2247
Mailing address
2801 'C' COURT, ASHTABULA, OH 44004
(440) 998-4210
(440) 998-2247
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
0166
OH
261QM0850X
Adult Mental Health Clinic/Center
0166
OH
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
0166
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0200508
—
OH
Enumeration date
06/10/2006
Last updated
03/04/2015
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