Basic Information
Provider Information | |||||||||
NPI: | 1689800898 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HOWERTON | ||||||||
FirstName: | NADEGE | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | LMFT | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 5000 AUTUMNWOOD LN | ||||||||
Address2: |   | ||||||||
City: | BRUNSWICK | ||||||||
State: | OH | ||||||||
PostalCode: | 442124724 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2164072864 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 611 W MARKET ST | ||||||||
Address2: |   | ||||||||
City: | AKRON | ||||||||
State: | OH | ||||||||
PostalCode: | 44303 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3309964600 | ||||||||
FaxNumber: | 3305649296 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/02/2009 | ||||||||
LastUpdateDate: | 05/30/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | M0700016 | OH | N |   | Behavioral Health & Social Service Providers | Marriage & Family Therapist |   | 106H00000X | M.0700016 | OH | Y |   | Behavioral Health & Social Service Providers | Marriage & Family Therapist |   |
No ID Information.