Creekside Counseling Center, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E-0003444-SUPV Issued in OH

Legal business name

CREEKSIDE COUNSELING CENTER, LLC

Practice address

106 S Broad St
Canfield, OH 44406-1447

Phone

(330) 533-5450

Fax

(330) 533-4292

NPI assigned

Mar 26, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Richard Kupec, MSEDNPI 1457320889

Title

Chief Excutive Manager

Phone

(330) 533-5450

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Thomas Richard Kupec, PSY.D, LPCC

  • Mental Health Counselor
  • Canfield, OH
  • NPI 1457320889
  Authorized official Same address or phone
• Anne Lally, LPCC-S

  • Mental Health Counselor
  • Canfield, OH
  • NPI 1225168149
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922126168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S BROAD ST",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444061447",
            "telephone_number": "330-533-5450",
            "fax_number": "330-533-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S BROAD ST",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444061447",
            "telephone_number": "330-533-5450",
            "fax_number": "330-533-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KUPEC",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "CHIEF EXCUTIVE MANAGER",
        "authorized_official_telephone_number": "330-533-5450",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSED"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E-0003444-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Christopher Cox, D.O.
• David Andrew Crans, D.D.S.
• Cassandra Crawford
• Linda S. Crawford, CT
• Creekside Counseling Center, LLC
• Terrance B Crogan, MA MS CAGS
• Julie Cross, DPT
• Bethany A Crouch
• Sharon Cuchacovich Francos, MFT-T
• Cheri Cutlip, AGPCNP

• Mental Health Counselor in Canfield, OH
• Providers in Canfield, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.