MEDICARE: JOAN LESLIE ODONOGHUE 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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	83976	OH

General Provider Information

NPI Number	:	1861623522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN LESLIE ODONOGHUE LICDC

Provider Business Mailing Address
First Line	:	6800 PEARL RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44130-3615
Country	:	US
Telephone Number	:	440-816-8200
Fax Number	:	440-816-8197

Provider Business Practice Location Address
First Line	:	7265 OLD OAK BLVD
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-3342
Country	:	US
Telephone Number	:	440-816-8200
Fax Number	:	440-816-8197

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

Provider Enumeration Date	:	07/29/2009
Last Update Date	:	03/30/2017

Similar Medicare Providers

1902897887 — DANIEL S POLSTER MD
Practice Location Address:

7265 OLD OAK BLVD
MIDDLEBURG HEIGHTS, OH
44130-3342

Practice Phone: 440-816-5790
Practice Fax: 440-816-5806

1093375180 — LAURA ANN BASCO MSN, PMHNP-BC
Practice Location Address:

7265 OLD OAK BLVD
MIDDLEBURG HEIGHTS, OH
44130-3342

Practice Phone: 440-816-8200
Practice Fax:

1679249650 — DARREN LUMLEY NP
Practice Location Address:

7265 OLD OAK BLVD
MIDDLEBURG HEIGHTS, OH
44130-3342

Practice Phone: 440-816-5790
Practice Fax:

1467328716 — ADELE LYNN DAVIDSON
Practice Location Address:

7265 OLD OAK BLVD
MIDDLEBURG HEIGHTS, OH
44130-3342

Practice Phone: 440-816-5755
Practice Fax:

1770854036 — A BETTER SOLUTION HOME CARE
Practice Location Address:

15412 BENHOFF DR
MAPLE HEIGHTS, OH
44137-3342

Practice Phone: 216-224-2702
Practice Fax:

1588295513 — SPENCER EDWARD FURLICH MS, AT, ATC, NREMT
Practice Location Address:

2735 DERBYSHIRE RD
CLEVELAND HEIGHTS, OH
44106-3342

Practice Phone: 216-301-8307
Practice Fax:

Directions to “ JOAN LESLIE ODONOGHUE LICDC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.