Basic Information
| Provider Information | |||||||||
| NPI: | 1215404579 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOUNT | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6140 S BROADWAY | ||||||||
| Address2: | |||||||||
| City: | LORAIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440533821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402337232 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6140 S BROADWAY | ||||||||
| Address2: | |||||||||
| City: | LORAIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440533821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402337232 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2018 | ||||||||
| LastUpdateDate: | 08/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | C.2002481-TRNE | OH | N | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | C.2002481-TRNE | OH | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 171M00000X | N | Other Service Providers | Case Manager/Care Coordinator | 101Y00000X | C.2103686 | OH | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.