| Cloudbreak Counseling Services, LLC | |
|
1029 Lake Ave Ashtabula OH 44004-2927 | |
| (440) 344-9029 | |
| Not Available |
| Full Name | Cloudbreak Counseling Services, LLC |
|---|---|
| Speciality | Counselor |
| Location | 1029 Lake Ave, Ashtabula, Ohio |
| Authorized Official Name and Position | Jamiee Imbrogno (OWNER/THERAPIST) |
| Authorized Official Contact | 4403449029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cloudbreak Counseling Services, LLC 1029 Lake Ave Ashtabula OH 44004-2927 Ph: (440) 344-9029 | Cloudbreak Counseling Services, LLC 1029 Lake Ave Ashtabula OH 44004-2927 Ph: (440) 344-9029 |
| NPI Number | 1780475178 |
|---|---|
| Provider Enumeration Date | 05/14/2025 |
| Last Update Date | 05/14/2025 |
| Certification Date | 05/14/2025 |
| Medicare PECOS PAC ID | 5294242921 |
|---|---|
| Medicare Enrollment ID | O20250728003878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780475178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| Provider Name | Jamiee K Imbrogno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013423094 PECOS PAC ID: 7911414644 Enrollment ID: I20250729004773 |
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