MEDICARE: MS. SUSAN RAKOW PC

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	101YM0800X	Mental Health Counselor	E1700479	OH

General Provider Information

NPI Number	:	1194140038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN RAKOW PC

Provider Business Mailing Address
First Line	:	26777 LORAIN ROAD
Second Line	:	HUMANISTIC COUNSELING CENTER SUITE 416
City	:	NORTH OOLMSTED
State	:	OH
Zip	:	44070
Country	:	US
Telephone Number	:	216-839-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	1824 WILTON RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-1629
Country	:	US
Telephone Number	:	216-932-3084
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2014
Last Update Date	:	08/11/2021

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