Provider Demographics
NPI:1437604741
Name:CERULA, STEPHANIE M (LPCC)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:M
Last Name:CERULA
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 1:8224 MENTOR AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5768
Mailing Address - Country:US
Mailing Address - Phone:440-392-2222
Mailing Address - Fax:440-565-2349
Practice Address - Street 1:8224 MENTOR AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5768
Practice Address - Country:US
Practice Address - Phone:440-392-2222
Practice Address - Fax:440-565-2349
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1500179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional