Healthcare Provider Details

I. General information

NPI: 1023462009
Provider Name (Legal Business Name): ANDREW K ROHDE LMFT, LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2016
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

398 W BAGLEY RD STE 13
BEREA OH
44017-1312
US

IV. Provider business mailing address

7519 MENTOR AVE STE 114
MENTOR OH
44060-5410
US

V. Phone/Fax

Practice location:
  • Phone: 440-970-3790
  • Fax: 440-527-8043
Mailing address:
  • Phone: 440-701-6170
  • Fax: 440-527-8043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2102178
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: