Provider Demographics
NPI:1053909077
Name:CONNECTIONS COUNSELING & MEDIATION SERVICES, LLC
Entity type:Organization
Organization Name:CONNECTIONS COUNSELING & MEDIATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:OTT
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:216-346-2578
Mailing Address - Street 1:3637 MEDINA RD STE 345A
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8152
Mailing Address - Country:US
Mailing Address - Phone:216-346-2578
Mailing Address - Fax:330-952-1008
Practice Address - Street 1:3637 MEDINA RD STE 345A
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8152
Practice Address - Country:US
Practice Address - Phone:216-346-2578
Practice Address - Fax:330-952-1008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health