Individual
CARMEN T GOMEZ-JEFFREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCC-ATR
Contact information
Practice address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
E.0500338-SUPV
OH
101YM0800X
Mental Health Counselor
E.0500338
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0213333
—
OH
Enumeration date
03/21/2011
Last updated
03/25/2024
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