Healthcare Provider Details

I. General information

NPI: 1275683716
Provider Name (Legal Business Name): LINDA ALLEN LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 10/19/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 W 25TH ST
CLEVELAND OH
44113-3108
US

IV. Provider business mailing address

1730 W 25TH ST
CLEVELAND OH
44113-3108
US

V. Phone/Fax

Practice location:
  • Phone: 216-363-2122
  • Fax: 440-312-9251
Mailing address:
  • Phone: 216-363-2122
  • Fax: 440-312-9251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.10000328
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: