=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083348783
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RAVZA OZTURK M.ED., LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2022
-----------------------------------------------------
Last Update Date | 01/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | SUMMIT ONE BUILDING 4700 ROCKSIDE ROAD SUITE 135
-----------------------------------------------------
City | INDEPENDENCE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-518-8334
-----------------------------------------------------
Fax | 440-628-8123
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4065 CANE RIDGE PKWY APT 405
-----------------------------------------------------
City | ANTIOCH
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37013-5171
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-370-9011
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | C.2204194
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------