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General NPI Number Information
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NPI Number | 1093846735
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Entity Type | Individual
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Provider Name | MICHAEL PAUL KEARNEY LPCC
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Gender | Male
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 30400 DETROIT RD SUITE 306
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City | WESTLAKE
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State | OH
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Zip | 44145-1872
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Country | US
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Telephone | 440-779-7324
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Fax | 440-617-1960
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Provider Business Mailing Address
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Address Line | 30400 DETROIT RD SUITE 306
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City | WESTLAKE
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State | OH
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Zip | 44145-1872
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Country | US
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Telephone | 440-779-7324
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Fax | 440-617-1960
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E 0002475
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License Number State | OH
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