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Marisa Wallace, LPC
Professional Counselor in Mentor, Ohio
NPI 1316417439

Marisa Wallace is a Professional Counselor based in Mentor, OH and is specialized in Professional. Marisa Wallace practices in Mentor, OH and has the professional credentials of LPC. The NPI Number for Marisa Wallace is 1316417439 and holds a License No. (Ohio).

The current practice location address for Marisa Wallace is 7232 Justin Way, Mentor, OH and can be reached out via phone at 440-578-8200. You can also correspond with Marisa Wallace through the mailing address at 7232 JUSTIN WAY, MENTOR, OH - 44060-4881 (mailing address contact number: 440-578-8200).

Location: 7232 Justin Way, Mentor, OH, 44060-4881
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316417439
Provider Name
Marisa Wallace
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
7232 Justin Way, Mentor, OH, 44060-4881
Phone Number
440-578-8200
Fax Number
Provider Enumeration Date
12/01/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
7232 Justin Way
City
Mentor
State
Ohio
Zip
44060-4881
Phone Number
440-578-8200
Fax Number
person
Provider Business Mailing Address Details
Address
7232 Justin Way
City
Mentor
State
Ohio
Zip
44060-4881
Phone Number
440-578-8200
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
C.190690 (Ohio)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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