Healthcare Provider Details

I. General information

NPI: 1033785241
Provider Name (Legal Business Name): KAILEY VILYUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2021
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25111 COUNTRY CLUB BLVD STE 290
NORTH OLMSTED OH
44070-5330
US

IV. Provider business mailing address

25111 COUNTRY CLUB BLVD STE 290
NORTH OLMSTED OH
44070-5330
US

V. Phone/Fax

Practice location:
  • Phone: 216-468-5002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC.2002882-TRNE
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2505909
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: