NPIMap

Organization Active NPI

Southwoods Counseling LLC

  • Psychiatry Physician
  • Boardman, OH
National Provider Identifier
1306168893
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SOUTHWOODS COUNSELING LLC
Practice address
833 Boardman Canfield Rd Ste 105
Boardman, OH 44512-4236
Phone
(330) 953-1964
Fax
(877) 253-7181
NPI assigned
Feb 24, 2010
Last updated
May 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
Sharon Ann Augustine
Title
Office Manager
Phone
(330) 953-1964

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

833 Boardman Canfield Rd Ste 105
Boardman, OH 44512-4236

Mailing address

908 Sahara TRL
Poland, OH 44514-3667

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100323000100 OH Part B Supplier - Clinic/Group Practice 1355476896 Receives reassigned benefits from 9 practitioners
Practice locations: Boardman, OH

National Provider Directory

National Provider Directory

Locations

833 Boardman Canfield Rd
Ste 105
Youngstown, OH 44512
Phone (330) 758-9751

908 Sahara Trl
Youngstown, OH 44514
Phone (330) 726-2965

Practitioners & affiliated clinicians

Practitioners 12

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": "1266969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1306168893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 SAHARA TRL",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 BOARDMAN CANFIELD RD STE 105",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124236",
            "telephone_number": "330-953-1964",
            "fax_number": "877-253-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWOODS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-24",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "AUGUSTINE",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-953-1964"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.