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NPI Code Detail

MEDICARE: MRS. SHARON ANN KUCZEK RN, LPC, LMFT

MEDICARE: MRS. SHARON ANN KUCZEK RN, LPC, LMFT
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
1106H00000XMarriage & Family TherapistM.1600034OH
2163W00000XRegistered NurseRN207708OH
3101YM0800XMental Health CounselorC.1500362OH

General Provider Information

NPI Number : 1962700765
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHARON ANN KUCZEK RN, LPC, LMFT
Provider Business Mailing Address
First Line : 2361 LEEWAY DR
Second Line :
City : HUDSON
State : OH
Zip : 44236-1844
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4300 LYNN RD STE 201
Second Line :
City : RAVENNA
State : OH
Zip : 44266-7838
Country : US
Telephone Number : 216-264-0008
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2011
Last Update Date : 03/13/2023

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