Healthcare Provider Details

I. General information

NPI: 1689673063
Provider Name (Legal Business Name): CYNTHIA SUSAN REICHLEY LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24500 CENTER RIDGE RD #100
WESTLAKE OH
44145-5601
US

IV. Provider business mailing address

24500 CENTER RIDGE RD #100
WESTLAKE OH
44145-5601
US

V. Phone/Fax

Practice location:
  • Phone: 440-899-1300
  • Fax: 440-899-0266
Mailing address:
  • Phone: 440-899-1300
  • Fax: 440-899-0266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberE-0002352
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: