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NPI Code Detail

MEDICARE: JENNIFER DODD LPC

MEDICARE: JENNIFER DODD LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorC.8442OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000488649OTHEROHANTHEM BLUE CROSS PIN

General Provider Information

NPI Number : 1285793794
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER DODD LPC
Provider Business Mailing Address
First Line : 2525 E 22ND ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-3202
Country : US
Telephone Number : 216-696-5800
Fax Number :
Provider Business Practice Location Address
First Line : 2525 E 22ND ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-3202
Country : US
Telephone Number : 216-696-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2006
Last Update Date : 07/08/2007

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