Healthcare Provider Details

I. General information

NPI: 1548832603
Provider Name (Legal Business Name): AVA SPATARO LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32625 DETROIT RD
AVON OH
44011-2013
US

IV. Provider business mailing address

37313 HARVEST AVE
AVON OH
44011-2803
US

V. Phone/Fax

Practice location:
  • Phone: 440-370-1385
  • Fax:
Mailing address:
  • Phone: 440-370-1385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2405836
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: