Healthcare Provider Details

I. General information

NPI: 1841135704
Provider Name (Legal Business Name): SPROUT MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 COBBLESTONE CT.
BEREA OH
44017
US

IV. Provider business mailing address

35966 DETROIT RD # 1006
AVON OH
44011-1653
US

V. Phone/Fax

Practice location:
  • Phone: 440-201-9142
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JACQUELYN CASALINA
Title or Position: OWNER
Credential: M.ED., LPCC-S
Phone: 440-201-9142