Provider Demographics
NPI:1962729343
Name:STOVER, JAMES A (MED, LPC, CRC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:STOVER
Suffix:
Gender:M
Credentials:MED, LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19505 FRAZIER DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-1630
Mailing Address - Country:US
Mailing Address - Phone:440-821-7380
Mailing Address - Fax:
Practice Address - Street 1:19505 FRAZIER DR
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-1630
Practice Address - Country:US
Practice Address - Phone:440-821-7380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0600636101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health