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NPI Code Detail

MEDICARE: COLLEEN MCCLEERY IMFT, LICDC

MEDICARE:   COLLEEN  MCCLEERY  IMFT, LICDC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor041001OH
2106H00000XMarriage & Family TherapistF126OH

General Provider Information

NPI Number : 1821186677
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN MCCLEERY IMFT, LICDC
Provider Business Mailing Address
First Line : 8689 EMERALD OVAL S
Second Line :
City : OLMSTED TWP
State : OH
Zip : 44138-4211
Country : US
Telephone Number : 440-465-7652
Fax Number :
Provider Business Practice Location Address
First Line : 8689 EMERALD OVAL S
Second Line :
City : OLMSTED TWP
State : OH
Zip : 44138-4211
Country : US
Telephone Number : 440-465-7652
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 05/05/2014

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Directions to “ COLLEEN MCCLEERY IMFT, LICDC” Practice Location

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