Provider Demographics
NPI:1407231574
Name:SANTILLI, PATRICK (LPCC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:SANTILLI
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19885 DETROIT RD # 264
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-1815
Mailing Address - Country:US
Mailing Address - Phone:440-271-3422
Mailing Address - Fax:
Practice Address - Street 1:3365 HIGLEY RD
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3832
Practice Address - Country:US
Practice Address - Phone:440-271-3422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1400686101YP2500X
OHE.1800809101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC.1400686OtherTHE COUNSELOR, SOCIAL WORKER AND MARRIAGE AND FAMILY THERAPIST BOARD
OHE.1800809OtherTHE COUNSELOR, SOCIAL WORKER AND MARRIAGE AND FAMILY THERAPIST BOARD