=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841164191
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COCREATE COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2025
-----------------------------------------------------
Last Update Date | 09/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 31100 PINETREE RD STE 226
-----------------------------------------------------
City | PEPPER PIKE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44124-5963
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-232-2583
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31100 PINETREE RD STE 226
-----------------------------------------------------
City | PEPPER PIKE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44124-5963
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-232-2583
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/THERAPIST
-----------------------------------------------------
Name | KATE KORTANEK
-----------------------------------------------------
Credential | LPCC-S LPAT
-----------------------------------------------------
Telephone | 216-232-2583
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------