Individual
JUDITH MARINICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCC, LICDC
Contact information
Practice address
38039 W SPAULDING ST, WILLOUGHBY, OH 44094-6110
(440) 918-1806
(440) 918-1807
Mailing address
38039 W SPAULDING ST, WILLOUGHBY, OH 44094-6110
(440) 918-1806
(440) 918-1807
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
981392
OH
101YM0800X
Mental Health Counselor
Primary
E-0003813
OH
104100000X
Social Worker
S-0017842
OH
Other
Enumeration date
07/21/2006
Last updated
07/17/2009
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