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NPI Code Detail

MEDICARE: MRS. ANANDA SOTHERLAND LPCC-S

MEDICARE:  MRS. ANANDA  SOTHERLAND  LPCC-S
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
1101YM0800XMental Health CounselorE.602067 SUPVOH

General Provider Information

NPI Number : 1346692878
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANANDA SOTHERLAND LPCC-S
Provider Business Mailing Address
First Line : 3100 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2508
Country : US
Telephone Number : 216-361-4400
Fax Number : 216-361-2340
Provider Business Practice Location Address
First Line : 14201 SOUTHINGTON RD
Second Line :
City : SHAKER HTS
State : OH
Zip : 44120-2703
Country : US
Telephone Number : 216-751-8453
Fax Number : 216-361-2340
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2016
Last Update Date : 07/08/2016

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Directions to “ MRS. ANANDA SOTHERLAND LPCC-S” Practice Location

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