Provider Demographics
NPI:1215339916
Name:JURICA, GREGORY (LPCC-S)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:JURICA
Suffix:
Gender:M
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 932909
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-2909
Mailing Address - Country:US
Mailing Address - Phone:330-854-4281
Mailing Address - Fax:
Practice Address - Street 1:6101 WHIPPLE AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7617
Practice Address - Country:US
Practice Address - Phone:330-537-8114
Practice Address - Fax:330-537-8063
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1300561101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional