Provider Demographics
NPI:1740727536
Name:SALPIETRO, CARLY (MA, LPC, AT)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:SALPIETRO
Suffix:
Gender:F
Credentials:MA, LPC, AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 GLEN PARK DR
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-2451
Mailing Address - Country:US
Mailing Address - Phone:419-704-1768
Mailing Address - Fax:
Practice Address - Street 1:20525 DETROIT RD
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-2444
Practice Address - Country:US
Practice Address - Phone:216-777-8834
Practice Address - Fax:216-502-2291
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1600648101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional