Healthcare Provider Details

I. General information

NPI: 1841321650
Provider Name (Legal Business Name): PHYLLIS ANN YEROPOLI MSED., LPC., LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4970 BELMONT AVE
YOUNGSTOWN OH
44505
US

IV. Provider business mailing address

4970 BELMONT AVE
YOUNGSTOWN OH
44505-1018
US

V. Phone/Fax

Practice location:
  • Phone: 330-759-8237
  • Fax: 330-759-9532
Mailing address:
  • Phone: 330-759-8237
  • Fax: 330-759-9532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC0000870
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS0003300
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: