| Live Well Counseling, Llc | |
|
7655 Mentor Ave # 311 Mentor OH 44060-5409 | |
| (440) 375-1821 | |
| (216) 744-1722 |
| Full Name | Live Well Counseling, Llc |
|---|---|
| Speciality | Counselor |
| Location | 7655 Mentor Ave # 311, Mentor, Ohio |
| Authorized Official Name and Position | Jeffrey Sustarsic (COUNSELOR) |
| Authorized Official Contact | 4403751821 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Well Counseling, Llc 7655 Mentor Ave # 311 Mentor OH 44060-5409 Ph: (440) 375-1821 | Live Well Counseling, Llc 7655 Mentor Ave # 311 Mentor OH 44060-5409 Ph: (440) 375-1821 |
| NPI Number | 1932860178 |
|---|---|
| Provider Enumeration Date | 01/09/2022 |
| Last Update Date | 01/09/2022 |
| Certification Date | 01/09/2022 |
| Medicare PECOS PAC ID | 6305378886 |
|---|---|
| Medicare Enrollment ID | O20241022003731 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932860178 | NPI | - | NPPES |
| 1588159933 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Kelsey Sustarsic |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891229522 PECOS PAC ID: 9931631413 Enrollment ID: I20241022004079 |
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