Healthcare Provider Details

I. General information

NPI: 1689220865
Provider Name (Legal Business Name): THAILIA MORTON LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5589 DUNHAM RD
MAPLE HEIGHTS OH
44137-3657
US

IV. Provider business mailing address

5589 DUNHAM RD
MAPLE HEIGHTS OH
44137-3657
US

V. Phone/Fax

Practice location:
  • Phone: 216-282-9667
  • Fax: 216-635-9667
Mailing address:
  • Phone: 216-282-9667
  • Fax: 216-635-9667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2002721
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.1901862-TRNE
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2404831
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: