Provider Type Icon

CENTER FOR REVOLUTIONARY RELATIONSHIPS LLC NPI 1710436415


NPI Information

NPI: 1710436415
Provider Name: CENTER FOR REVOLUTIONARY RELATIONSHIPS LLC
Classification: Marriage & Family Therapist - 106H00000X
Entity Type: Organization
Address:
3200 W. MARKET ST.
STE. 101
FAIRLAWN, OH
ZIP 44333
Phone: (330) 459-6743
Get Directions

CENTER FOR REVOLUTIONARY RELATIONSHIPS LLC is a marriage family therapist in Fairlawn, OH. The provider is a marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. CENTER FOR REVOLUTIONARY RELATIONSHIPS LLC NPI is 1710436415. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3200 W. MARKET ST.
STE. 101
FAIRLAWN, OH
ZIP 44333-324
Phone: (330) 459-6743
Fax: (330) 595-8006

The provider's authorized official is Monica Padula .
The authorized official title is Owner/lisw and has the following contact phone number (330) 459-6743.

The enumeration date for this NPI number is 9/23/2016 and was last updated on 3/27/2023.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1106H00000XMarriage & Family TherapistI0005980OHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11871701953OTHERNPI

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.