Provider Demographics
NPI:1306317623
Name:MAVROIDIS, YIANNOULA (LPCC-S, BC-TMH)
Entity type:Individual
Prefix:
First Name:YIANNOULA
Middle Name:
Last Name:MAVROIDIS
Suffix:
Gender:F
Credentials:LPCC-S, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34679 VINE ST
Mailing Address - Street 2:
Mailing Address - City:WILLOWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44095-5119
Mailing Address - Country:US
Mailing Address - Phone:216-284-0463
Mailing Address - Fax:
Practice Address - Street 1:34679 VINE ST
Practice Address - Street 2:
Practice Address - City:WILLOWICK
Practice Address - State:OH
Practice Address - Zip Code:44095-5119
Practice Address - Country:US
Practice Address - Phone:216-284-0463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-14
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional