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NPI Code Detail

MEDICARE: MRS. EMILY RACHEL FECKLEY CDCA

MEDICARE:  MRS. EMILY RACHEL FECKLEY  CDCA
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) CounselorCDCA173718OH

General Provider Information

NPI Number : 1821602897
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EMILY RACHEL FECKLEY CDCA
Provider Business Mailing Address
First Line : 13377 SMITH RD
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-7810
Country : US
Telephone Number : 440-340-5558
Fax Number : 440-340-5575
Provider Business Practice Location Address
First Line : 13377 SMITH RD
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-7810
Country : US
Telephone Number : 440-340-5558
Fax Number : 440-340-5575
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2020
Last Update Date : 06/30/2021

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Directions to “ MRS. EMILY RACHEL FECKLEY CDCA” Practice Location

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