Provider Demographics
NPI:1720662968
Name:OUR COUPLE COUNSELOR LLC
Entity Type:Organization
Organization Name:OUR COUPLE COUNSELOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NOELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMUDIO
Authorized Official - Suffix:
Authorized Official - Credentials:LIMFT-S, LPC
Authorized Official - Phone:216-713-4474
Mailing Address - Street 1:8507 TAHOE DR
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-2734
Mailing Address - Country:US
Mailing Address - Phone:216-255-8544
Mailing Address - Fax:
Practice Address - Street 1:24100 CHAGRIN BLVD STE 125
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5535
Practice Address - Country:US
Practice Address - Phone:216-714-3278
Practice Address - Fax:800-879-1741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty