Healthcare Provider Details

I. General information

NPI: 1528971538
Provider Name (Legal Business Name): LEA BUONAVOLONTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3645 STUTZ DR
CANFIELD OH
44406-9168
US

IV. Provider business mailing address

3645 STUTZ DR
CANFIELD OH
44406-9168
US

V. Phone/Fax

Practice location:
  • Phone: 330-967-4111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2607950-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: