Healthcare Provider Details

I. General information

NPI: 1215330246
Provider Name (Legal Business Name): ELISABETH COUTS LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2014
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2992 KEW DR
COVENTRY TOWNSHIP OH
44319-1711
US

IV. Provider business mailing address

645 HOWE AVE # 1149
CUYAHOGA FALLS OH
44221-4955
US

V. Phone/Fax

Practice location:
  • Phone: 330-617-5005
  • Fax: 133-061-7563
Mailing address:
  • Phone: 330-617-5005
  • Fax: 330-617-5639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.130693
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.1800708-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: