Provider Demographics
NPI:1356889646
Name:PISANELLI, ALYSSA LYNN (LPCC-S, LICDC)
Entity type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:LYNN
Last Name:PISANELLI
Suffix:
Gender:F
Credentials:LPCC-S, LICDC
Other - Prefix:MRS
Other - First Name:ALYSSA
Other - Middle Name:LYNN
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC-S, LICDC
Mailing Address - Street 1:616 IRVING PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44054-1624
Mailing Address - Country:US
Mailing Address - Phone:440-731-7593
Mailing Address - Fax:
Practice Address - Street 1:616 IRVING PARK BLVD
Practice Address - Street 2:
Practice Address - City:SHEFFIELD LAKE
Practice Address - State:OH
Practice Address - Zip Code:44054-1624
Practice Address - Country:US
Practice Address - Phone:440-731-7593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2202698-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health