MEDICARE: ARBOR SANA COUNSELING & WELLNESS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	5168	OH

General Provider Information

NPI Number	:	1023039963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARBOR SANA COUNSELING & WELLNESS INC

Provider Business Mailing Address
First Line	:	2639 WOOSTER RD
Second Line	:	SUITE 4
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-2911
Country	:	US
Telephone Number	:	440-665-6506
Fax Number	:	440-331-2692

Provider Business Practice Location Address
First Line	:	671 COLUMBIA RD STE 8
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-1477
Country	:	US
Telephone Number	:	440-895-0366
Fax Number	:	440-331-2692

Authorized Official
Title or Position	:	OWNER OF PRACTICE
Name	:	THERESA BRIXIUS
Credential	:
Telephone Number	:	440-895-0366

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	09/01/2022

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