MEDICARE: HOLLY ANNE CUNDIFF 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
1	101YP2500X	Professional Counselor	E4038	OH

General Provider Information

NPI Number	:	1821175613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY ANNE CUNDIFF LPCC

Provider Business Mailing Address
First Line	:	2500 METROHEALTH DR
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-1900
Country	:	US
Telephone Number	:	216-778-7800
Fax Number	:

Provider Business Practice Location Address
First Line	:	ONE PERKINS SQUARE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44308-1062
Country	:	US
Telephone Number	:	330-543-7476
Fax Number	:	330-543-7474

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	01/26/2012

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