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General NPI Number Information
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NPI Number | 1275924391
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Entity Type | Organization
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Legal Business Name | WESTERN RESERVE COUNSELING LLC
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Dates
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Enumeration Date | 02/11/2015
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 33448 SHELLY CT
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City | AVON LAKE
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State | OH
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Zip | 44012-1129
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Country | US
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Telephone | 440-822-8248
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Fax | 440-377-6490
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Provider Business Mailing Address
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Address Line | 4773 SISSON RD
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City | TITUSVILLE
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State | FL
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Zip | 32780-7227
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Country | US
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Telephone | 440-822-8248
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Fax | 440-377-6490
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Authorized Official
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Title or Position | PROVIDER
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Name | MRS. ROBIN M HALE
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Credential | LPCC, LICDC
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Telephone | 440-822-2248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | E.0050965SUPV
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License Number State | OH
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