Healthcare Provider Details

I. General information

NPI: 1669083598
Provider Name (Legal Business Name): MARY BRIDGETT HOLZHEIMER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9826 WASHINGTON ST
CHAGRIN FALLS OH
44023-5401
US

IV. Provider business mailing address

9826 WASHINGTON ST
CHAGRIN FALLS OH
44023-5401
US

V. Phone/Fax

Practice location:
  • Phone: 234-269-6200
  • Fax: 234-602-2192
Mailing address:
  • Phone: 440-708-0188
  • Fax: 440-708-0368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.0500775
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0500775
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: