Counseling Center of Wayne & Holmes Counties

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

COUNSELING CENTER OF WAYNE & HOLMES COUNTIES

Practice address

2285 Benden Dr
Wooster, OH 44691-2568

Phone

(330) 264-9029

NPI assigned

Feb 25, 2019

Last updated

Feb 25, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

SOURCEONE GROUP INCAs reported in NPPES

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

Authorized official

Name

Diane Susan Derue, MPA, LSWNPI 1518063767

Title

Vice President

Phone

(330) 264-9029

Specialties & licenses 2

Addresses

Tax ID family

Cnslg Ctr of Wayne-Holm2 organizations share this tax ID, including this one

Part of

Sourceone Group Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Counseling Center of Wayne & Holmes Counties

  • Community/Behavioral Health Agency
  • Wooster, OH
  • NPI 1215975685
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Sourceone Group Inc

  dba SourceOne

  • Adult Mental Health Clinic/Center
  • Wooster, OH
  • NPI 1447346564
  NPPES parent name

Practitioners 1

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.

• Diane Susan Derue, MPA, LSW

  • Clinical Social Worker
  • Wooster, OH
  • NPI 1518063767
  Authorized official Same address or phone

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551052800000",
    "number": "1467919605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 BENDEN DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912568",
            "telephone_number": "330-264-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 BENDEN DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912568",
            "telephone_number": "330-264-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING CENTER OF WAYNE & HOLMES COUNTIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOURCEONE GROUP INC",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A",
        "authorized_official_last_name": "DERUE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "330-264-9029",
        "authorized_official_credential": "MPA, LSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colin Michael Cottrell
• Mindy Sue Cottrell
• Tracy Lynn Cottrell, QMHS
• Jules Marie Cottrill, LSW
• Counseling Center of Wayne & Holmes Counties
• Country Pointe, Inc. (Country Pointe)
• Sarah R. Courtemanche, MSW, LSW
• Margie Courtney
• Coveny Chiropractic and Wellness, LLC
• Kenneth E Covey, PH.D.

• Substance Use Disorder Rehabilitation Clinic/Center in Wooster, OH
• Providers in Wooster, OH by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.