Healthcare Provider Details

I. General information

NPI: 1689583148
Provider Name (Legal Business Name): ALYSSA CORRIGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9220 MENTOR AVE
MENTOR OH
44060-6412
US

IV. Provider business mailing address

9220 MENTOR AVE
MENTOR OH
44060-6412
US

V. Phone/Fax

Practice location:
  • Phone: 440-251-4622
  • Fax:
Mailing address:
  • Phone: 440-255-1700
  • Fax: 440-205-2417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: