Provider Demographics
NPI:1619009867
Name:ANNE, NANCY (LPC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:ANNE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:ANNE
Other - Last Name:MALONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:250 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143
Mailing Address - Country:US
Mailing Address - Phone:216-261-8005
Mailing Address - Fax:216-261-2414
Practice Address - Street 1:250 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:RICHMOND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143
Practice Address - Country:US
Practice Address - Phone:216-261-8005
Practice Address - Fax:216-261-2414
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0004745101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional