Provider Demographics
NPI:1700396819
Name:CLOUSE, LINNEA REBEKAH (LPC)
Entity Type:Individual
Prefix:
First Name:LINNEA
Middle Name:REBEKAH
Last Name:CLOUSE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 E 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-2603
Mailing Address - Country:US
Mailing Address - Phone:614-224-4506
Mailing Address - Fax:614-291-0118
Practice Address - Street 1:547 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2603
Practice Address - Country:US
Practice Address - Phone:614-224-4506
Practice Address - Fax:614-291-0118
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1700345101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional