Healthcare Provider Details

I. General information

NPI: 1184315921
Provider Name (Legal Business Name): KATHERINE KIRKHOLDER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20525 DETROIT RD STE 8
ROCKY RIVER OH
44116-2444
US

IV. Provider business mailing address

20525 DETROIT RD STE 8
ROCKY RIVER OH
44116-2444
US

V. Phone/Fax

Practice location:
  • Phone: 216-777-8834
  • Fax:
Mailing address:
  • Phone: 216-777-8834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2607341
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: