NPIMap

Organization Active NPI

Summit Therapy Center LLC

  • Social Worker
  • Wooster, OH
National Provider Identifier
1093856494
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S-0012173 Issued in OH
Legal business name
SUMMIT THERAPY CENTER LLC
Practice address
4419 Cleveland Rd
Wooster, OH 44691-1233
Phone
(330) 345-8450
Fax
(330) 345-5899
NPI assigned
Feb 9, 2007
Last updated
Nov 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chevelle Snyder
Title
Billing Specialist
Phone
(419) 464-6907

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X E0008036 OH
Counselor 101Y00000X I7261 OH
Social Worker 104100000X S-0018817 OH
Social Worker 104100000X S-0012173 OH Primary

Addresses

Primary practice location

4419 Cleveland Rd
Wooster, OH 44691-1233

Mailing address

4419 Cleveland Rd
Wooster, OH 44691-1233
Phone (330) 345-8450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250314002982 OH Part B Supplier - Clinic/Group Practice 0840712295 Receives reassigned benefits from 4 practitioners
Practice locations: Wooster, OH

National Provider Directory

National Provider Directory

Locations

4419 Cleveland Rd
Wooster, OH 44691
Phone (330) 345-8450

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1093856494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 CLEVELAND RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911233",
            "telephone_number": "330-345-8450",
            "fax_number": "330-345-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 CLEVELAND RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911233",
            "telephone_number": "330-345-8450",
            "fax_number": "330-345-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "CHEVELLE",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "419-464-6907"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E0008036",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "I7261",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S-0018817",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S-0012173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.