Healthcare Provider Details

I. General information

NPI: 1306951017
Provider Name (Legal Business Name): ZEV S ASHENBERG PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 01/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6449 WILSON MILLS RD
MAYFIELD VILLAGE OH
44143-3438
US

IV. Provider business mailing address

6449 WILSON MILLS RD
MAYFIELD VILLAGE OH
44143-3438
US

V. Phone/Fax

Practice location:
  • Phone: 440-442-8800
  • Fax: 440-442-8804
Mailing address:
  • Phone: 440-442-8800
  • Fax: 440-442-8804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3439
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3439
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: