Provider Demographics
NPI:1508373671
Name:SLAIN, JODY (LPCC)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:SLAIN
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 1:23250 CHAGRIN BLVD STE 425
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5445
Mailing Address - Country:US
Mailing Address - Phone:216-464-4243
Mailing Address - Fax:216-595-8210
Practice Address - Street 1:23250 CHAGRIN BLVD STE 425
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5445
Practice Address - Country:US
Practice Address - Phone:216-464-4243
Practice Address - Fax:216-595-8210
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-10
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1800922101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health