MEDICARE: MS. KIRSTIN A ESCH MA, PCC-S, LCDC-III

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	051033	OH
2	101YP2500X	Professional Counselor	E4313	OH
3	101Y00000X	Counselor	E.0004313-SUPV	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740386531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIRSTIN A ESCH MA, PCC-S, LCDC-III

Provider Business Mailing Address
First Line	:	7232 JUSTIN WAY
Second Line	:	SIGNATURE HEALTH INC
City	:	MENTOR
State	:	OH
Zip	:	44060-4881
Country	:	US
Telephone Number	:	440-578-8200
Fax Number	:

Provider Business Practice Location Address
First Line	:	7232 JUSTIN WAY
Second Line	:	SIGNATURE HEALTH INC
City	:	MENTOR
State	:	OH
Zip	:	44060-4406
Country	:	US
Telephone Number	:	440-578-8200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	04/13/2021

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