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NPI Code Detail

MEDICARE: MISS SUMATHI V. MUDDENAHALLI M.ED., LPCC

MEDICARE: MISS SUMATHI V. MUDDENAHALLI M.ED., LPCC
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 CounselorC1801193OH
2101YM0800XMental Health CounselorC.1801193OH

General Provider Information

NPI Number : 1720560782
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS SUMATHI V. MUDDENAHALLI M.ED., LPCC
Provider Business Mailing Address
First Line : 2285 BENDEN DR
Second Line :
City : WOOSTER
State : OH
Zip : 44691-2568
Country : US
Telephone Number : 330-264-9029
Fax Number : 330-263-7251
Provider Business Practice Location Address
First Line : 2285 BENDEN DR
Second Line :
City : WOOSTER
State : OH
Zip : 44691-2568
Country : US
Telephone Number : 330-264-9029
Fax Number : 330-263-7251
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2018
Last Update Date : 05/18/2026

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