| Organization Name: | CONNEAUT PSYCHIATRIC SERVICES, LLC |
| NPI Number: | 1063827491 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONNA L. WORKMAN (OWNER) |
| Mailing Address: | 177 West St Conneaut |
| State: | OH US |
| Postal Code: | 440302153 |
| Phone Number: | 4402280506 |
| Fax Number: | 4405935799 |
| NPI Enumeration Date: | 06/24/2014 |
| NPI Last Update Date: | 09/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |