Healthcare Provider Details

I. General information

NPI: 1316609225
Provider Name (Legal Business Name): CHRISTINA MICHELLE ALBALADEJO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 09/02/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 BENEDICT AVE
NORWALK OH
44857-2374
US

IV. Provider business mailing address

292 BENEDICT AVE
NORWALK OH
44857-2374
US

V. Phone/Fax

Practice location:
  • Phone: 419-663-3737
  • Fax: 419-663-5096
Mailing address:
  • Phone: 419-663-3737
  • Fax: 419-663-5096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC.2204544
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2204544
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: