Healthcare Provider Details

I. General information

NPI: 1215218755
Provider Name (Legal Business Name): KATIE MUSA IMFT-S, LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2011
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6785 WALLINGS RD
NORTH ROYALTON OH
44133-3024
US

IV. Provider business mailing address

PO BOX 42
HINCKLEY OH
44233-0042
US

V. Phone/Fax

Practice location:
  • Phone: 440-457-7474
  • Fax:
Mailing address:
  • Phone: 440-447-0515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: