Individual
KATHERINE KONCILJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LPCC
Contact information
Practice address
215 MILLER RD STE 7, AVON LAKE, OH 44012-1013
(440) 742-1661
(440) 653-9576
Mailing address
215 MILLER RD STE 7, AVON LAKE, OH 44012-1013
(440) 742-1661
(440) 653-9576
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
090037
OH
101YP2500X
Professional Counselor
Primary
E1000011
OH
Other
Enumeration date
06/14/2010
Last updated
12/19/2019
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