Healthcare Provider Details

I. General information

NPI: 1588257836
Provider Name (Legal Business Name): ALEXANDRA CRACIUN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRA GARIK LPC

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

771 N FREEDOM ST
RAVENNA OH
44266-2470
US

IV. Provider business mailing address

520 N CHESTNUT ST
RAVENNA OH
44266-2218
US

V. Phone/Fax

Practice location:
  • Phone: 330-296-5552
  • Fax: 330-296-6126
Mailing address:
  • Phone: 330-296-5552
  • Fax: 330-296-6126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2103897
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: