| Stella Luna Counseling And Wellness | |
|
17951 Jefferson Park Rd Ste 100 Middleburg Heights OH 44130-8439 | |
| (440) 879-8517 | |
| Not Available |
| Full Name | Stella Luna Counseling And Wellness |
|---|---|
| Speciality | Counselor |
| Location | 17951 Jefferson Park Rd Ste 100, Middleburg Heights, Ohio |
| Authorized Official Name and Position | Jennifer Lynne Digiandomenico (OWNER) |
| Authorized Official Contact | 4408798517 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stella Luna Counseling And Wellness 17951 Jefferson Park Rd Ste 100 Middleburg Heights OH 44130-8439 Ph: (440) 879-8517 | Stella Luna Counseling And Wellness 17951 Jefferson Park Rd Ste 100 Middleburg Heights OH 44130-8439 Ph: (440) 879-8517 |
| NPI Number | 1033854658 |
|---|---|
| Provider Enumeration Date | 04/28/2022 |
| Last Update Date | 11/21/2022 |
| Certification Date | 11/21/2022 |
| Medicare PECOS PAC ID | 2062889611 |
|---|---|
| Medicare Enrollment ID | O20221110001819 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033854658 | NPI | - | NPPES |
| 0000405 | Medicaid | OH |
| Provider Name | Diane T Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659708428 PECOS PAC ID: 7315258555 Enrollment ID: I20150615002206 |
| Provider Name | Christina Redfern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740896273 PECOS PAC ID: 3971922139 Enrollment ID: I20201007003108 |
| Provider Name | Stephanie Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437643103 PECOS PAC ID: 8426460684 Enrollment ID: I20201210003042 |
| Provider Name | Lisa Marie Barto |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649532987 PECOS PAC ID: 7911342811 Enrollment ID: I20240301001634 |
| Provider Name | Carrie M Callahan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760973622 PECOS PAC ID: 1951746692 Enrollment ID: I20240304002354 |
| Provider Name | Brock Owen Bodenbender |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750815452 PECOS PAC ID: 6103261755 Enrollment ID: I20240305002287 |
| Provider Name | Jennifer Lynne Digiandomenico |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457841322 PECOS PAC ID: 2961879515 Enrollment ID: I20240306001890 |
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