Individual
MRS. RACHEL A CONN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC-S, LICDC
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.0800247-SUPV
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
111026
OH
101YP2500X
Professional Counselor
E0800247
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164090
—
OH
Enumeration date
01/18/2012
Last updated
03/29/2021
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