Provider Demographics
NPI:1962088435
Name:MURGOLA, THERESA MARIE (LPCC)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:MARIE
Last Name:MURGOLA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:MARIE
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:77 MILFORD DR STE 218
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-2779
Mailing Address - Country:US
Mailing Address - Phone:330-650-4423
Mailing Address - Fax:330-655-4329
Practice Address - Street 1:77 MILFORD DR STE 218
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-2779
Practice Address - Country:US
Practice Address - Phone:330-650-4423
Practice Address - Fax:330-655-4329
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2204001101YP2500X
390200000X
OHE.2404547101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program