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NPI Code Detail

MEDICARE: MS. ELISA MARY GAGLIARDI LPCC-S, LICDC

MEDICARE:  MS. ELISA MARY GAGLIARDI  LPCC-S, LICDC
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 CounselorE2202OH

General Provider Information

NPI Number : 1568537116
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELISA MARY GAGLIARDI LPCC-S, LICDC
Provider Business Mailing Address
First Line : 7416 ESSEX DR
Second Line :
City : MENTOR
State : OH
Zip : 44060-5222
Country : US
Telephone Number : 440-951-8405
Fax Number : 440-285-4552
Provider Business Practice Location Address
First Line : 12557 RAVENWOOD DR
Second Line :
City : CHARDON
State : OH
Zip : 44024-9009
Country : US
Telephone Number : 440-285-3568
Fax Number : 440-285-4552
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 07/08/2007

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Directions to “ MS. ELISA MARY GAGLIARDI LPCC-S, LICDC” Practice Location

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