Healthcare Provider Details

I. General information

NPI: 1518522143
Provider Name (Legal Business Name): TRG COUNSELING COACHING & CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 RICHMOND RD STE 1005
BEACHWOOD OH
44122-1390
US

IV. Provider business mailing address

10622 LAKE SHORE BLVD
BRATENAHL OH
44108-1017
US

V. Phone/Fax

Practice location:
  • Phone: 216-223-8530
  • Fax:
Mailing address:
  • Phone: 216-223-8530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TANA GADELSAYED
Title or Position: OWNER
Credential: LISW-S
Phone: 216-223-8530