Healthcare Provider Details

I. General information

NPI: 1801716162
Provider Name (Legal Business Name): EMILY WISWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 JAYCOX RD
NORTH RIDGEVILLE OH
44039-1611
US

IV. Provider business mailing address

6401 JAYCOX RD
NORTH RIDGEVILLE OH
44039-1611
US

V. Phone/Fax

Practice location:
  • Phone: 440-327-1800
  • Fax: 440-327-1533
Mailing address:
  • Phone: 440-327-1800
  • Fax: 440-327-1533

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: