PORTAGE PATH BEHAVIORAL HEALTH (NPI# 1114492147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114492147 |
| Entity Type | Organization |
| Organization Name | PORTAGE PATH BEHAVIORAL HEALTH |
| Practice Address |
340 S Broadway St Akron OH 44308-1529 |
| Practice Telephone | 3302533100 |
| Practice Fax Number | 3302535248 |
| Mailing Telephone | 3302533100 |
| Mailing Fax Number | 3302535248 |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2018-10-05 |
| Authorized Official Name | JESSICA BAHRY (DIRECTOR OF ACCOUNTING) |
| Authorized Official Telephone | 3302533100 |
| Is Organization Subpart | Y |
| Parent Organization Name | PORTAGE PATH BEHAVIORAL HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881643633 | Portage Path Behavioral Health | Clinic/Center | 10 Penfield Ave, Akron, OH 44310-2912 | 2006-05-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PORTAGE PATH BEHAVIORAL HEALTH | 340 S Broadway St, Akron, OH 44308-1529 |
| Street Address |
340 S BROADWAY ST |
| City | AKRON |
| State | OH |
| Zip Code | 44308-1529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093797490 | Stacey Sue Kline | Pharmacist | 340 S Broadway St, Akron, OH 44308-1529 | 2005-11-19 |
| 1235736844 | Stephanie Kaye Walker | Counselor | 340 S Broadway St, Akron, OH 44308-1529 | 2020-10-06 |
| 1700499829 | Kristen Shaughnessy | Registered Nurse | 340 S Broadway St, Akron, OH 44308-1529 | 2020-08-28 |
| 1720691942 | Adam Christopher Brown | Registered Nurse | 340 S Broadway St, Akron, OH 44308-1529 | 2020-08-27 |
| 1356953079 | Kiarra King | Student in an Organized Health Care Education/Training Program | 340 S Broadway St, Akron, OH 44308-1529 | 2020-08-24 |
| 1245849520 | Cheyenne Phillips | Case Manager/Care Coordinator | 340 S Broadway St, Akron, OH 44308-1529 | 2020-07-23 |
| 1578188009 | Jade Branch | Counselor | 340 S Broadway St, Akron, OH 44308-1529 | 2020-06-10 |
| 1295386043 | Rachael Dabkowski | Psychologist | 340 S Broadway St, Akron, OH 44308-1529 | 2019-09-24 |
| 1053961284 | Samsara Soto | Student in an Organized Health Care Education/Training Program | 340 S Broadway St, Akron, OH 44308-1529 | 2019-09-19 |
| 1891342770 | Jusiah Prowell | Student in an Organized Health Care Education/Training Program | 340 S Broadway St, Akron, OH 44308-1529 | 2019-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285267096 | Terrence Shambley | Specialist/Technologist | 333 S Mainst Suite 607, Akron, OH 44308 | 2020-02-20 |
| 1750865028 | Christian Bates | Case Manager/Care Coordinator | 333 S.main Street, Akron, OH 44308 | 2018-09-21 |
| 1558854471 | Sheryl Alyssa Mendoza | Case Manager/Care Coordinator | 333 S Main St Ste 607333, Akron, OH 44308 | 2018-06-14 |
| 1033608260 | Angela Leigh Capuano Fant | Student in an Organized Health Care Education/Training Program | 340 South Broadway Street, Akron, OH 44308 | 2018-05-03 |
| 1639686918 | Crystal Louise Mann | Counselor | 90 N Summit St, Akron, OH 44308 | 2018-01-08 |
| 1174074173 | Jameela Hawkins | Counselor | 333 S Main St Ste 607, Akron, OH 44308 | 2016-10-14 |
| 1164817219 | Elizabeth Theresa Stephens | Pediatrics | 214 W Bowery St, Akron, OH 44308 | 2015-04-04 |
| 1407105596 | Rebecca Wasserman Lieb | Psychologist | 215 W. Bowery Street, Consodine Professional Building, Akron, OH 44308 | 2012-09-05 |
| 1871895573 | Crystal Joyce | Pediatrics | 1 Perkins Sqaure, Medical Education, Akron, OH 44308 | 2010-12-01 |
| 1508000431 | Emily Lee Wiland | Pediatrics | 177 West Exchange Street, 6th Floor Room 61118, Akron, OH 44308 | 2009-04-22 |
| Find all providers in zip 44308 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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|---|---|---|---|---|
| 1548222656 | Vantage Aging | Clinic/Center | 2279 Romig Rd, Akron, OH 44320 | 2006-04-04 |
| 1235658709 | Centennial Mental Health Center, Inc. | Clinic/Center | 871 E 1st St, Akron, CO 80720-1705 | 2017-09-15 |
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| 1205455508 | Sunrise Treatment Center - Piqua | Clinic/Center | 1130 Garbry Rd, Piqua, OH 45356-8217 | 2020-04-16 |
| 1043863384 | Team Recovery Ohio, LLC | Clinic/Center | 1618 W Sylvania Ave, Toledo, OH 43612-1589 | 2019-07-16 |
| 1568926376 | Square One Health LLC | Clinic/Center | 620 W 44th St, Ashtabula, OH 44004-6812 | 2019-01-25 |
| 1700357829 | Lovel Henderson Jr | Clinic/Center | 6600 Lexington Ave, Cleveland, OH 44103 | 2018-12-16 |
| 1669942934 | Baymark Health Services of Ohio | Clinic/Center | 833 E Broad St Unit 1, Elyria, OH 44035-6557 | 2018-11-29 |
| 1841760113 | Baymark Health Services of Ohio | Clinic/Center | 36001 Euclid Ave Ste B1, Willoughby, OH 44094-4643 | 2018-11-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.