Healthcare Provider Details

I. General information

NPI: 1184869786
Provider Name (Legal Business Name): PREMIER BEHAVIORAL HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2008
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 MENTOR AVE
MENTOR OH
44060-6103
US

IV. Provider business mailing address

8701 MENTOR AVE
MENTOR OH
44060-6103
US

V. Phone/Fax

Practice location:
  • Phone: 440-266-0770
  • Fax: 440-266-0257
Mailing address:
  • Phone: 440-266-0770
  • Fax: 440-266-0257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6237
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: ROBERTA URSETTI
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 440-266-0770