Provider Demographics
NPI:1679725501
Name:AHERN, JANE E (PCC-S-)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:E
Last Name:AHERN
Suffix:
Gender:F
Credentials:PCC-S-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17860 NORTHWOOD LAKES DR
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-2218
Mailing Address - Country:US
Mailing Address - Phone:440-227-0676
Mailing Address - Fax:
Practice Address - Street 1:17860 NORTHWOOD LAKES DR
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-2218
Practice Address - Country:US
Practice Address - Phone:440-227-0676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0007322101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health