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General NPI Number Information
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NPI Number | 1316089675
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Entity Type | Individual
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Provider Name | KORINNE STANICH LPCC
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 34900 CHARDON RD
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City | WILLOUGHBY HILLS
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State | OH
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Zip | 44094-9161
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Country | US
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Telephone | 440-951-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 8249 LANCASTER DR
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City | MENTOR
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State | OH
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Zip | 44060-4247
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Country | US
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Telephone | 216-990-6224
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Fax |
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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 | C.0500215.TEMP
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.0500215
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License Number State | OH
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