Susan C Vesely, LPCC

Individual provider Active NPI Professional Counselor · Mentor, OH

NPI 1639200090 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1639200090
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
E0004165 (OH)
Practice address
7350 Palisades Pkwy
Mentor, OH 44060-5302
Phone
(440) 918-1000
Fax
(440) 918-1029
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
E0004165OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Inc Past Accepting new patients
Pathways Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E0004165 OH Yes

Addresses

Primary practice location

7350 Palisades Pkwy
Mentor, OH 44060-5302

Mailing address

13240 Stoney Springs Dr
Chardon, OH 44024-8957
Phone (440) 635-9971

Other providers in Mentor, OH

All providers in Mentor, OH · Professional Counselor in Ohio

Sources for this page

Verify at the official NPI Registry.