Healthcare Provider Details

I. General information

NPI: 1437730280
Provider Name (Legal Business Name): MR. BRIAN C. HART
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23625 COMMERCE PARK
BEACHWOOD OH
44122-5845
US

IV. Provider business mailing address

3 PEPPER RIDGE RD
PEPPER PIKE OH
44124-4904
US

V. Phone/Fax

Practice location:
  • Phone: 216-831-4410
  • Fax:
Mailing address:
  • Phone: 216-640-5052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2410478
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: