Nicholas Glenn Barracato

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Kent, OH

NPI 1720640709 · NPPES record last updated Dec 13, 2024

Key facts

NPI
1720640709
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CDCA.174561 (OH)
Practice address
143 Gougler Ave
Kent, OH 44240-2401
Phone
(330) 677-4724
NPI assigned
Jul 1, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CDCA.174561OHMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.174561 OH Yes
Community Health Worker 172V00000X

Addresses

Primary practice location

143 Gougler Ave
Kent, OH 44240-2401

Mailing address

150 E Market St
Warren, OH 44481-1141
Phone (330) 399-6451

Other providers in Kent, OH

All providers in Kent, OH · Addiction (Substance Use Disorder) Counselor in Ohio

Sources for this page

Verify at the official NPI Registry.