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Individual

TELISA CROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC

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.1901249
OH
101YM0800X
Mental Health Counselor
IMH13259
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0293135
OH
Enumeration date
07/14/2014
Last updated
04/14/2021
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