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General NPI Number Information
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NPI Number | 1386570786
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Entity Type | Organization
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Legal Business Name | WANDERING WILLOWS COUNSELING LLC
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 1440 ROCKSIDE RD STE 322C
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City | PARMA
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State | OH
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Zip | 44134-2749
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Country | US
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Telephone | 216-694-1285
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Fax |
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Provider Business Mailing Address
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Address Line | 4521 FRUITLAND DR
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City | PARMA
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State | OH
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Zip | 44134-4534
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Country | US
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Telephone | 216-694-1285
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | JILLIAN ANN DECARLO
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Credential | LPCC
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Telephone | 216-694-1285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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