Provider Demographics
NPI:1811916034
Name:RAPP, SALLY P (LPCC)
Entity type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:P
Last Name:RAPP
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31571 SCHWARTZ RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-3760
Mailing Address - Country:US
Mailing Address - Phone:440-892-0452
Mailing Address - Fax:440-892-3472
Practice Address - Street 1:24551 DETROIT RD
Practice Address - Street 2:STE 5
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2592
Practice Address - Country:US
Practice Address - Phone:440-892-0452
Practice Address - Fax:440-892-3472
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2840101Y00000X, 101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
10339712Medicare UPIN
1399600Medicare UPIN
3323999Medicare UPIN
000000141019Medicare UPIN
506666Medicare UPIN
888433Medicare UPIN
499604Medicare UPIN
7732457Medicare UPIN