| Aliza M. Prokop Counseling Services, Llc | |
|
5114 Ken Ln Vienna OH 44473-9723 | |
| (330) 716-0182 | |
| Not Available |
| Full Name | Aliza M. Prokop Counseling Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 5114 Ken Ln, Vienna, Ohio |
| Authorized Official Name and Position | Aliza Prokop (OWNER) |
| Authorized Official Contact | 3307160182 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aliza M. Prokop Counseling Services, Llc 5114 Ken Ln Vienna OH 44473-9723 Ph: () - | Aliza M. Prokop Counseling Services, Llc 5114 Ken Ln Vienna OH 44473-9723 Ph: (330) 716-0182 |
| NPI Number | 1295466639 |
|---|---|
| Provider Enumeration Date | 06/17/2022 |
| Last Update Date | 06/17/2022 |
| Certification Date | 06/17/2022 |
| Medicare PECOS PAC ID | 1850738063 |
|---|---|
| Medicare Enrollment ID | O20240325000048 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295466639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Aliza Prokop |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457080194 PECOS PAC ID: 5597102707 Enrollment ID: I20240325000039 |
Sweet Therapy Counseling Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 547 Niles Vienna Rd, Vienna, OH 44473 Phone: 330-519-9539 Fax: 716-219-5048 |