Provider Demographics
NPI:1396519682
Name:A HOME 4 THERAPY LLC
Entity type:Organization
Organization Name:A HOME 4 THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:330-967-0366
Mailing Address - Street 1:4496 MAHONING AVE # 1038
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-1601
Mailing Address - Country:US
Mailing Address - Phone:330-967-0366
Mailing Address - Fax:855-975-2436
Practice Address - Street 1:8064 CAMDEN WAY
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-8164
Practice Address - Country:US
Practice Address - Phone:330-967-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty