Healthcare Provider Details

I. General information

NPI: 1457819732
Provider Name (Legal Business Name): REBECCA MANOCCHIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2019
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SUPERIOR AVE
CLEVELAND OH
44114-2614
US

IV. Provider business mailing address

600 SUPERIOR AVE
CLEVELAND OH
44114-2614
US

V. Phone/Fax

Practice location:
  • Phone: 740-996-7100
  • Fax:
Mailing address:
  • Phone: 646-941-7645
  • Fax: 929-596-7897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2606074
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: