Provider Demographics
NPI:1821696352
Name:UNITY WELLNESS, LLC
Entity Type:Organization
Organization Name:UNITY WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:DELUCA
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:440-409-3304
Mailing Address - Street 1:28601 CHAGRIN BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4556
Mailing Address - Country:US
Mailing Address - Phone:440-291-5467
Mailing Address - Fax:
Practice Address - Street 1:28601 CHAGRIN BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:OH
Practice Address - Zip Code:44122-4556
Practice Address - Country:US
Practice Address - Phone:440-291-5467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0422447Medicaid