Wanderwomen LTD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

WANDERWOMEN LTD

Practice address

614 High St
Fairport Harbor, OH 44077-5638

Phone

(440) 313-6076

NPI assigned

Jun 16, 2022

Last updated

Nov 21, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Krystal Klingemier, LPCCNPI 1417405507

Title

Owner/Therapist

Phone

(440) 313-6076

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Krystal Klingemier, LPCC

  • Professional Counselor
  • Fairport Harbor, OH
  • NPI 1417405507

  Mental Health

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1447980800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 HIGH ST",
            "city": "FAIRPORT HARBOR",
            "state": "OH",
            "postal_code": "440775638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 HIGH ST",
            "city": "FAIRPORT HARBOR",
            "state": "OH",
            "postal_code": "440775638",
            "telephone_number": "440-313-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANDERWOMEN LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-16",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A",
        "authorized_official_last_name": "KLINGEMIER",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "440-313-6076",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen M Tizzano
• Anna Tyrrell, M.ED., LSW, LPCC
• Laura Marie Urban
• Natalie Marie Urban
• Village of Fairport Harbor

• Mental Health Counselor in Fairport Harbor, OH
• Providers in Fairport Harbor, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.