Healthcare Provider Details

I. General information

NPI: 1932896420
Provider Name (Legal Business Name): CHRISTINA AXELROD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24723 CEDAR RD STE 10
LYNDHURST OH
44124-3786
US

IV. Provider business mailing address

1377 WORTON BLVD
MAYFIELD HTS OH
44124-1760
US

V. Phone/Fax

Practice location:
  • Phone: 216-403-3234
  • Fax: 216-516-3634
Mailing address:
  • Phone: 216-403-3234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: