NPIMap

Organization Active NPI

Community Counseling Center of Ashtabula County

  • Adolescent and Children Mental Health Clinic/Center
  • Ashtabula, OH
National Provider Identifier
1720029622
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
0166 Issued in OH
Legal business name
COMMUNITY COUNSELING CENTER OF ASHTABULA COUNTY
Practice address
2801 C CT
Ashtabula, OH 44004-4577
Phone
(440) 998-4210
Fax
(440) 998-2247
NPI assigned
Jun 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Authorized official

Name
Mr. Paul Samuel Bolino, M.S,ED.,LPCC-S, CDCA
Title
Ceo
Phone
(440) 998-4210

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 0166 OH
Adult Mental Health Clinic/Center 261QM0850X 0166 OH
Adolescent and Children Mental Health Clinic/Center 261QM0855X 0166 OH Primary

Addresses

Primary practice location

2801 C CT
Ashtabula, OH 44004-4577

Mailing address

2801 'C' Court
Ashtabula, OH 44004
Phone (440) 998-4210

Other identifiers 1

IdentifierTypeStateIssuer
0200508MedicaidOH

National Provider Directory

National Provider Directory

Locations

216 Main St
Ste D
Conneaut, OH 44030

500 W Main St
Geneva, OH 44041

Practitioners & affiliated clinicians

Practitioners 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780272000000",
    "number": "1720029622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 'C' COURT",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "44004",
            "telephone_number": "440-998-4210",
            "fax_number": "440-998-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 C CT",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044577",
            "telephone_number": "440-998-4210",
            "fax_number": "440-998-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNSELING CENTER OF ASHTABULA COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A",
        "authorized_official_last_name": "BOLINO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "440-998-4210",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S,ED.,LPCC-S, CDCA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OH",
            "license": "0166",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "OH",
            "license": "0166",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "OH",
            "license": "0166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0200508",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.