Individual
NICOLE LEANNE SKUFCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
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
C.1901736
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0312595
—
OH
Enumeration date
08/30/2018
Last updated
09/12/2021
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