Organization Active NPI

Family Connection of Wadsworth

  • Marriage & Family Therapist
  • Wadsworth, OH
National Provider Identifier
1497060602
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
M 09000007 Issued in OH
Legal business name
FAMILY CONNECTION OF WADSWORTH
Practice address
140 Wadsworth Rd
Wadsworth, OH 44281
Phone
(330) 730-7353
Fax
(330) 334-2235
NPI assigned
Aug 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Authorized official

Name
Joanne M Holbert, ED.S.NPI 1700190410
Title
Owner/Therapist
Phone
(330) 730-7353

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TS0200X SP 490 OH
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X M 09000007 OH Primary

Addresses

Primary practice location

140 Wadsworth Rd
Wadsworth, OH 44281

Mailing address

140 Wadsworth Rd
Wadsworth, OH 44281
Phone (330) 730-7353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240516000649 OH Part B Supplier - Clinic/Group Practice 7214378686 Receives reassigned benefits from 1 practitioner
Practice locations: Wadsworth, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1497060602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 WADSWORTH RD",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "44281",
            "telephone_number": "330-730-7353",
            "fax_number": "330-334-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 WADSWORTH RD",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "44281",
            "telephone_number": "330-730-7353",
            "fax_number": "330-334-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CONNECTION OF WADSWORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-11",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "HOLBERT",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "330-730-7353",
        "authorized_official_credential": "ED.S."
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "SP 490",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "M 09000007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadsworth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.