Healthcare Provider Details

I. General information

NPI: 1629797493
Provider Name (Legal Business Name): ELENA DARAH LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELENA KIRKBRIDE

II. Dates (important events)

Enumeration Date: 08/25/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 COMMERCE DR
PERRYSBURG OH
43551-5256
US

IV. Provider business mailing address

3909 WOODLEY RD
TOLEDO OH
43606-1169
US

V. Phone/Fax

Practice location:
  • Phone: 419-872-2419
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2305482
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: