Provider Demographics
NPI:1164946455
Name:BIANCHI, TESSA (LPCC)
Entity Type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:BIANCHI
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 S TRIMBLE RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-4112
Mailing Address - Country:US
Mailing Address - Phone:419-756-9975
Mailing Address - Fax:419-756-1405
Practice Address - Street 1:605 S TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-4112
Practice Address - Country:US
Practice Address - Phone:419-756-9975
Practice Address - Fax:419-756-1405
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE.0602246OtherLICENSE NUMBER