Provider Demographics
NPI:1134605306
Name:FLYNN, STEPHANIE RINALDI (LPCC, NCC)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:RINALDI
Last Name:FLYNN
Suffix:
Gender:F
Credentials:LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19676 STOUGHTON DR
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44149-5656
Mailing Address - Country:US
Mailing Address - Phone:404-465-3515
Mailing Address - Fax:216-739-3639
Practice Address - Street 1:3518 W 25TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1951
Practice Address - Country:US
Practice Address - Phone:216-741-2241
Practice Address - Fax:216-739-3639
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2202814101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC.1801210-TRNEOtherCHANGE QMHS TO CT STATUS