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General NPI Number Information
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NPI Number | 1548766512
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Entity Type | Organization
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Legal Business Name | DRAKE COUNSELING GROUP
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Dates
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Enumeration Date | 03/30/2018
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Last Update Date | 03/30/2018
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Provider Practice Location Address
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Address Line | 540 E 105TH ST STE 208
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City | CLEVELAND
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State | OH
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Zip | 44108-1394
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Country | US
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Telephone | 216-588-1313
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Fax | 216-588-1428
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Provider Business Mailing Address
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Address Line | 540 E 105TH ST STE 208
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City | CLEVELAND
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State | OH
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Zip | 44108-1394
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Country | US
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Telephone | 216-588-1313
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Fax | 216-588-1428
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Authorized Official
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Title or Position | CEO/CLINICAL THERAPIST
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Name | MS. MISIT DRAKE
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Credential | LPCC
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Telephone | 216-588-1313
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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.0007996
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License Number State | OH
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