Healthcare Provider Details

I. General information

NPI: 1043946635
Provider Name (Legal Business Name): ASCEND BEHAVIORAL HEALTH & ADDICTION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 AVON BELDEN RD
AVON LAKE OH
44012-2204
US

IV. Provider business mailing address

537 PARKSIDE DR
BAY VILLAGE OH
44140-2552
US

V. Phone/Fax

Practice location:
  • Phone: 440-427-4571
  • Fax:
Mailing address:
  • Phone: 330-285-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SETH GARCIA
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: PHD
Phone: 440-427-4571