| Rockport Counseling Llc | |
|
14805 Detroit Ave Ste 450 Lakewood OH 44107-3920 | |
| (216) 412-2200 | |
| (216) 803-6723 |
| Full Name | Rockport Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 14805 Detroit Ave Ste 450, Lakewood, Ohio |
| Authorized Official Name and Position | Michael Crowdes (PRESIDENT) |
| Authorized Official Contact | 2164122200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rockport Counseling Llc 14805 Detroit Ave Ste 450 Lakewood OH 44107-3920 Ph: (216) 412-2200 | Rockport Counseling Llc 14805 Detroit Ave Ste 450 Lakewood OH 44107-3920 Ph: (216) 412-2200 |
| NPI Number | 1629734702 |
|---|---|
| Provider Enumeration Date | 11/12/2021 |
| Last Update Date | 11/12/2021 |
| Certification Date | 11/12/2021 |
| Medicare PECOS PAC ID | 1355871419 |
|---|---|
| Medicare Enrollment ID | O20250205002187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629734702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Michael Anthony Crowdes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205440906 PECOS PAC ID: 5698119436 Enrollment ID: I20240220001956 |
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