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PERRYSBURG THERAPY LLC NPI 1073054219


NPI Information

NPI: 1073054219
Provider Name: PERRYSBURG THERAPY LLC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

CLIA Number: 36D2180412

Address:
830 W SOUTH BOUNDARY ST
SUITE A
PERRYSBURG, OH
ZIP 43551
Phone: (419) 931-3020
Get Directions

PERRYSBURG THERAPY LLC is a clinical social worker in Perrysburg, OH. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. PERRYSBURG THERAPY LLC NPI is 1073054219. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

830 W SOUTH BOUNDARY ST
SUITE A
PERRYSBURG, OH
ZIP 43551-238
Phone: (419) 931-3020
Fax: (419) 931-3022

The provider's authorized official is Craig Burrow .
The authorized official title is Owner and has the following contact phone number (419) 931-3020.

The CLIA number assigned to this NPI record is 36D2180412 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/20/2017 and was last updated on 3/20/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental HealthE1600096OHIONo
2101YM0800XCounselorMental HealthC1300382OHIONo
3101YM0800XCounselorMental HealthE1700029OHIONo
41041C0700XSocial WorkerClinicalI-000-5829-SOHIOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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