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1000 S Cleveland Massillon Rd Ste 1 Akron OH 44333-9204 | |
| (866) 951-4325 | |
| (330) 266-4372 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1000 S Cleveland Massillon Rd Ste 1, Akron, Ohio |
| Authorized Official Name and Position | Nicholas Angelis (CEO) |
| Authorized Official Contact | 3307544844 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1000 S Cleveland Massillon Rd Suite 1 Akron OH 44333-9204 Ph: (330) 754-4844 | 1000 S Cleveland Massillon Rd Ste 1 Akron OH 44333-9204 Ph: (866) 951-4325 |
| NPI Number | 1912470303 |
|---|---|
| Provider Enumeration Date | 01/08/2019 |
| Last Update Date | 08/19/2021 |
| Certification Date | 05/20/2021 |
| Medicare PECOS PAC ID | 4284969114 |
|---|---|
| Medicare Enrollment ID | O20190715000841 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912470303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Tamara Bowling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134569478 PECOS PAC ID: 7113169244 Enrollment ID: I20130820000257 |
| Provider Name | Nicholas M Angelis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871801225 PECOS PAC ID: 2567655228 Enrollment ID: I20170913000744 |
| Provider Name | Stephanie Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194131490 PECOS PAC ID: 5294009411 Enrollment ID: I20170926003447 |
| Provider Name | Carlos Molina Arriola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437578804 PECOS PAC ID: 3274825351 Enrollment ID: I20180918003626 |
| Provider Name | Mark F Garretson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538694617 PECOS PAC ID: 0547500324 Enrollment ID: I20190313002228 |
| Provider Name | Susan Novak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134557077 PECOS PAC ID: 8224368584 Enrollment ID: I20190930001481 |
| Provider Name | Stefanie M Young |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053653402 PECOS PAC ID: 7416394101 Enrollment ID: I20240318000284 |
| Provider Name | Amanda Leigh Ludwick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700233012 PECOS PAC ID: 8527406214 Enrollment ID: I20240401000557 |
| Provider Name | Daniel R Langer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598866733 PECOS PAC ID: 4284619206 Enrollment ID: I20240606001556 |
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