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General NPI Number Information
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NPI Number | 1518472018
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Entity Type | Organization
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Legal Business Name | MS KUZILA LPCC LLC
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Dates
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Enumeration Date | 12/06/2017
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Last Update Date | 12/08/2017
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Provider Practice Location Address
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Address Line | 24600 CENTER RIDGE RD STE 133
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City | WESTLAKE
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State | OH
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Zip | 44145-5679
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Country | US
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Telephone | 440-525-2124
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Fax |
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Provider Business Mailing Address
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Address Line | 24600 CENTER RIDGE RD STE 133
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City | WESTLAKE
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State | OH
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Zip | 44145-5679
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Country | US
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Telephone | 440-525-2124
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Fax |
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Authorized Official
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Title or Position | CLINICAL COUNSELOR
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Name | MARYANN S KUZILA
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Credential | LPCC-S
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Telephone | 440-525-2124
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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 | E6901
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License Number State | OH
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