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General NPI Number Information
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NPI Number | 1790329654
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Entity Type | Organization
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Legal Business Name | LAKEWOOD COUNSELING, LLC
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Dates
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Enumeration Date | 11/04/2019
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Last Update Date | 11/04/2019
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Provider Practice Location Address
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Address Line | 16004 DETROIT AVE
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City | LAKEWOOD
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State | OH
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Zip | 44107-3713
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Country | US
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Telephone | 440-463-7603
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Fax |
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Provider Business Mailing Address
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Address Line | 1038 HOMEWOOD DR
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City | LAKEWOOD
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State | OH
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Zip | 44107-1420
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Country | US
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Telephone | 440-463-7603
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WENDY BIELLO
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Credential | LISW
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Telephone | 440-463-7603
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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 |
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License Number State |
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