| Western Reserve Counseling Llc | |
|
33448 Shelly Ct Avon Lake OH 44012-1129 | |
| (440) 822-8248 | |
| (440) 377-6490 |
| Full Name | Western Reserve Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 33448 Shelly Ct, Avon Lake, Ohio |
| Authorized Official Name and Position | Robin M Hale (PROVIDER) |
| Authorized Official Contact | 4408222248 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Reserve Counseling Llc 4773 Sisson Rd Titusville FL 32780-7227 Ph: (440) 822-8248 | Western Reserve Counseling Llc 33448 Shelly Ct Avon Lake OH 44012-1129 Ph: (440) 822-8248 |
| NPI Number | 1275924391 |
|---|---|
| Provider Enumeration Date | 02/11/2015 |
| Last Update Date | 01/22/2025 |
| Certification Date | 01/22/2025 |
| Medicare PECOS PAC ID | 6800166372 |
|---|---|
| Medicare Enrollment ID | O20240129002299 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275924391 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | E.0050965SUPV (Ohio) | Primary |
| Provider Name | Robin M Hale |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841599248 PECOS PAC ID: 3971873340 Enrollment ID: I20240129002666 |
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