Organization
CREEKSIDE COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS RICHARD KUPEC MSED (CHIEF EXCUTIVE MANAGER)
(330) 533-5450
Entity
Organization
Contact information
Practice address
106 S BROAD ST, CANFIELD, OH 44406-1447
(330) 533-5450
(330) 533-4292
Mailing address
106 S BROAD ST, CANFIELD, OH 44406-1447
(330) 533-5450
(330) 533-4292
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E-0003444-SUPV
OH
Other
Enumeration date
03/26/2007
Last updated
08/22/2020
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