Healthcare Provider Details

I. General information

NPI: 1619338969
Provider Name (Legal Business Name): ANNA PERRIELLO-MAYER LPCC-S, LICDC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10427 DETROIT AVE
CLEVELAND OH
44102-1645
US

IV. Provider business mailing address

10427 DETROIT AVE
CLEVELAND OH
44102-1645
US

V. Phone/Fax

Practice location:
  • Phone: 216-521-6511
  • Fax: 216-521-4006
Mailing address:
  • Phone: 216-521-6511
  • Fax: 216-521-4006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0008418-SUPV
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number151094
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: