Healthcare Provider Details

I. General information

NPI: 1750201059
Provider Name (Legal Business Name): JANB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2179 EDGERTON RD
UNIVERSITY HEIGHTS OH
44118-3001
US

IV. Provider business mailing address

2179 EDGERTON RD
UNIVERSITY HEIGHTS OH
44118-3001
US

V. Phone/Fax

Practice location:
  • Phone: 440-478-2529
  • Fax:
Mailing address:
  • Phone: 440-478-2529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM DEFELICE
Title or Position: OWNER
Credential: LPCC-S AND LICDC-CS
Phone: 440-478-2529