Healthcare Provider Details

I. General information

NPI: 1528207123
Provider Name (Legal Business Name): ZEV S. ASHENBERG, PHD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2009
Last Update Date: 02/05/2009
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 TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3439
License Number StateOH

VIII. Authorized Official

Name: ZEV S ASHENBERG
Title or Position: OWNER
Credential: PHD
Phone: 440-442-8800