Healthcare Provider Details

I. General information

NPI: 1730542226
Provider Name (Legal Business Name): MAHMOUD RIYAD ASSAD LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

842 CORPORATE WAY STE 800
WESTLAKE OH
44145-1569
US

IV. Provider business mailing address

7877 WILLOW CHASE BLVD
HOUSTON TX
77070-5934
US

V. Phone/Fax

Practice location:
  • Phone: 440-213-1239
  • Fax:
Mailing address:
  • Phone: 832-869-4818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2203061
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: