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NPI Code Detail

MEDICARE: PSYCHOLOGICAL COUNSELING SOLUTIONS, LLC

MEDICARE: PSYCHOLOGICAL COUNSELING SOLUTIONS, 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
11041C0700XClinical Social WorkerI0700452 SUPVOH

General Provider Information

NPI Number : 1861639866
Entity Type Code : Organization
Provider Name (Legal Business Name) : PSYCHOLOGICAL COUNSELING SOLUTIONS, LLC
Provider Business Mailing Address
First Line : 37303 HARVEST AVE
Second Line :
City : AVON
State : OH
Zip : 44011-2803
Country : US
Telephone Number : 440-799-2595
Fax Number : 440-930-2085
Provider Business Practice Location Address
First Line : 37303 HARVEST AVE
Second Line :
City : AVON
State : OH
Zip : 44011-2803
Country : US
Telephone Number : 440-799-2595
Fax Number : 440-934-2725
Authorized Official
Title or Position : CLINICAL THERAPIST & SOLE PROPRIETO
Name : LANA AMAWI
Credential : MSSA, LISW-S
Telephone Number : 440-799-2595
Provider Enumeration Date : 01/13/2009
Last Update Date : 12/10/2012

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Directions to “PSYCHOLOGICAL COUNSELING SOLUTIONS, LLC ” Practice Location

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