Healthcare Provider Details

I. General information

NPI: 1417445297
Provider Name (Legal Business Name): IASC COUNSELING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8251 MAYFIELD RD STE 202
CHESTERLAND OH
44026-2567
US

IV. Provider business mailing address

8004 WILSON MILLS RD
CHESTERLAND OH
44026-1853
US

V. Phone/Fax

Practice location:
  • Phone: 216-577-8292
  • Fax:
Mailing address:
  • Phone: 216-577-8292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberI.1600358
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberI.1600358
License Number StateOH

VIII. Authorized Official

Name: MRS. ISABEL A SANCHEZ CUMMINGS
Title or Position: PRESIDENT AND SOCIAL WORKER
Credential: MSSA, LISW, MPA
Phone: 440-490-6680