MEDICARE: WHOLISTIC COUNSELING CENTER LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1760128904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLISTIC COUNSELING CENTER LLC

Provider Business Mailing Address
First Line	:	18321 EDGERTON RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44119-2007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18321 EDGERTON RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44119-2007
Country	:	US
Telephone Number	:	216-586-4372
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DORIS RHODES
Credential	:	LPCC
Telephone Number	:	216-586-4372

Provider Enumeration Date	:	05/10/2022
Last Update Date	:	01/30/2024

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Directions to “WHOLISTIC COUNSELING CENTER LLC ” Practice Location

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