| Theravault, Llc | |
|
185 S Liberty St Powell OH 43065-7619 | |
| (888) 875-8712 | |
| Not Available |
| Full Name | Theravault, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 185 S Liberty St, Powell, Ohio |
| Authorized Official Name and Position | Amy Smitke (CO-OWNER) |
| Authorized Official Contact | 8888758712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Theravault, Llc 7736 Birchmont Dr Chagrin Falls OH 44022-3970 Ph: (888) 875-8712 | Theravault, Llc 185 S Liberty St Powell OH 43065-7619 Ph: (888) 875-8712 |
| NPI Number | 1922674563 |
|---|---|
| Provider Enumeration Date | 06/03/2021 |
| Last Update Date | 08/17/2022 |
| Certification Date | 08/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922674563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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