Healthcare Provider Details

I. General information

NPI: 1225320690
Provider Name (Legal Business Name): EILEEN M PAPPALARDO PCC, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2011
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1744 PAYNE AVE
CLEVELAND OH
44114-2910
US

IV. Provider business mailing address

20525 CENTER RIDGE RD STE 502
ROCKY RIVER OH
44116-3424
US

V. Phone/Fax

Practice location:
  • Phone: 216-623-6555
  • Fax:
Mailing address:
  • Phone: 440-799-4717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.1100164
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.1100164
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: