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General NPI Number Information
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NPI Number | 1457726762
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Entity Type | Individual
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Provider Name | ANNA TYRRELL M.ED., LSW, LPCC
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Gender | Female
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Dates
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Enumeration Date | 12/11/2015
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 611 PLUM ST.
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City | FAIRPORT HARBOR
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State | OH
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Zip | 44077
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Country | US
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Telephone | 440-953-1214
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1141
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City | MENTOR
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State | OH
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Zip | 44061-1141
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Country | US
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Telephone | 440-476-2958
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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 | E.2505307
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.2505307
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License Number State | OH
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