| Sophia Center Inc | |
|
6832 Convent Blvd Sylvania OH 43560-4805 | |
| (419) 882-4529 | |
| (419) 885-7612 |
| Full Name | Sophia Center Inc |
|---|---|
| Speciality | Psychologist |
| Location | 6832 Convent Blvd, Sylvania, Ohio |
| Authorized Official Name and Position | Rachel Marie Nijakowski (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4198824529 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sophia Center Inc 6832 Convent Blvd Sylvania OH 43560-4805 Ph: (419) 882-4529 | Sophia Center Inc 6832 Convent Blvd Sylvania OH 43560-4805 Ph: (419) 882-4529 |
| NPI Number | 1962474932 |
|---|---|
| Provider Enumeration Date | 02/03/2006 |
| Last Update Date | 08/19/2008 |
| Medicare PECOS PAC ID | 4385628346 |
|---|---|
| Medicare Enrollment ID | O20040616001038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962474932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| Provider Name | Rachel Marie Nijakowski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003896572 PECOS PAC ID: 0547244519 Enrollment ID: I20040727001678 |
| Provider Name | Craig M Ward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174618656 PECOS PAC ID: 0749375988 Enrollment ID: I20071002000778 |
| Provider Name | Leah M Cavanaugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811984081 PECOS PAC ID: 7113059627 Enrollment ID: I20100720000191 |
| Provider Name | Ildiko E Crawford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750419503 PECOS PAC ID: 2163683350 Enrollment ID: I20120416000367 |
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