Healthcare Provider Details

I. General information

NPI: 1447164827
Provider Name (Legal Business Name): RUSTIC HEARTH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5167 CHESTNUT HILL DR
WILLOUGHBY OH
44094-4339
US

IV. Provider business mailing address

5167 CHESTNUT HILL DR
WILLOUGHBY OH
44094-4339
US

V. Phone/Fax

Practice location:
  • Phone: 440-251-8568
  • Fax:
Mailing address:
  • Phone: 440-251-8568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: JENNIFER WINEBERG
Title or Position: OWNER
Credential: LPCC
Phone: 440-251-8568