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General NPI Number Information
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NPI Number | 1588080816
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Entity Type | Organization
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Legal Business Name | FAMILY ALLIANCE COUNSELING LLC
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Dates
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Enumeration Date | 03/11/2014
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Last Update Date | 12/22/2024
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Provider Practice Location Address
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Address Line | 31674 CENTER RIDGE RD STE 204
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City | NORTH RIDGEVILLE
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State | OH
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Zip | 44039-2401
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Country | US
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Telephone | 440-787-5355
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Fax | 440-281-8978
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Provider Business Mailing Address
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Address Line | 31674 CENTER RIDGE RD STE 204
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City | NORTH RIDGEVILLE
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State | OH
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Zip | 44039-2401
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Country | US
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Telephone | 440-787-5355
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | GINNY CARUSO
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Credential | LISW
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Telephone | 440-787-5355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.1101050
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License Number State | OH
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