Healthcare Provider Details

I. General information

NPI: 1376479162
Provider Name (Legal Business Name): EMERALD CITY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19511 PURITAS AVE
CLEVELAND OH
44135-1061
US

IV. Provider business mailing address

19511 PURITAS AVE
CLEVELAND OH
44135-1061
US

V. Phone/Fax

Practice location:
  • Phone: 216-224-1021
  • Fax:
Mailing address:
  • Phone: 216-224-1021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: MS. ANN MARIE PETRICCA
Title or Position: OWNER/THERAPIST
Credential: M.ED., LPCC
Phone: 216-224-1021