MEDICARE: PATRICIA M. WELLE L.P.C.C.

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	E4088	OH

General Provider Information

NPI Number	:	1760458822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA M. WELLE L.P.C.C.

Provider Business Mailing Address
First Line	:	28870 CHARDON RD
Second Line	:
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44092-2614
Country	:	US
Telephone Number	:	216-514-1575
Fax Number	:

Provider Business Practice Location Address
First Line	:	28870 CHARDON RD
Second Line	:
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44092-2614
Country	:	US
Telephone Number	:	216-514-1575
Fax Number	:

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

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	12/01/2016

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Directions to “ PATRICIA M. WELLE L.P.C.C.” Practice Location

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