Provider Demographics
NPI:1346692878
Name:SOTHERLAND, ANANDA (LPCC-S)
Entity Type:Individual
Prefix:MRS
First Name:ANANDA
Middle Name:
Last Name:SOTHERLAND
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2508
Mailing Address - Country:US
Mailing Address - Phone:216-361-4400
Mailing Address - Fax:216-361-2340
Practice Address - Street 1:14201 SOUTHINGTON RD
Practice Address - Street 2:
Practice Address - City:SHAKER HTS
Practice Address - State:OH
Practice Address - Zip Code:44120-2703
Practice Address - Country:US
Practice Address - Phone:216-751-8453
Practice Address - Fax:216-361-2340
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.602067 SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health