Provider Demographics
NPI:1992172290
Name:ZAMUDIO, NOELLE CHAPPELLE
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:CHAPPELLE
Last Name:ZAMUDIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:
Other - Last Name:CHAPPELLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LIMFT, LPC
Mailing Address - Street 1:6603 TAMARIND DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-4842
Mailing Address - Country:US
Mailing Address - Phone:216-714-3278
Mailing Address - Fax:800-879-1741
Practice Address - Street 1:24100 CHAGRIN BLVD STE 370
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5535
Practice Address - Country:US
Practice Address - Phone:216-714-3278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1100321-CR101YP2500X
OHF1600024106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional