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General NPI Number Information
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NPI Number | 1639200090
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Entity Type | Individual
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Provider Name | SUSAN C VESELY LPCC
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7350 PALISADES PKWY
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City | MENTOR
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State | OH
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Zip | 44060-5302
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Country | US
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Telephone | 440-918-1000
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Fax | 440-918-1029
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Provider Business Mailing Address
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Address Line | 13240 STONEY SPRINGS DR
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City | CHARDON
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State | OH
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Zip | 44024-8957
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Country | US
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Telephone | 440-635-9971
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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 | E0004165
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License Number State | OH
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