Provider Demographics
NPI:1225259559
Name:OPALICH, RENEE (LPCC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:OPALICH
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 1:4655 WATERFORD CIR
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-5366
Mailing Address - Country:US
Mailing Address - Phone:330-697-3613
Mailing Address - Fax:
Practice Address - Street 1:5868 STUMPH RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44130-1736
Practice Address - Country:US
Practice Address - Phone:440-888-5407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0602049101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional