Basic Information
| Provider Information | |||||||||
| NPI: | 1508261181 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CONARD | ||||||||
| FirstName: | CHAD | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 365 RIFFEL RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | WOOSTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 446918592 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303453461 | ||||||||
| FaxNumber: | 3303453462 | ||||||||
| Practice Location | |||||||||
| Address1: | 711 BELMONT AVE | ||||||||
| Address2: | |||||||||
| City: | YOUNGSTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445021039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307932487 | ||||||||
| FaxNumber: | 3307435748 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2014 | ||||||||
| LastUpdateDate: | 04/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | C1300461 | OH | N | Behavioral Health & Social Service Providers | Counselor | Professional | 101YM0800X | E.1300461 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP2500X | E.1300461 | OH | N | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.