Healthcare Provider Details

I. General information

NPI: 1023938990
Provider Name (Legal Business Name): STREAM HEALTH ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 7TH AVE STE 224
CHARDON OH
44024-1087
US

IV. Provider business mailing address

100 7TH AVE STE 224
CHARDON OH
44024-1087
US

V. Phone/Fax

Practice location:
  • Phone: 440-313-1427
  • Fax:
Mailing address:
  • Phone: 440-313-1427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JESSICA TOMASELLO
Title or Position: EXECUTIVE DIRECTOR
Credential: MHA, RDN
Phone: 440-313-1427