Healthcare Provider Details

I. General information

NPI: 1134121510
Provider Name (Legal Business Name): BEHAVIORAL HEALTH CONSULTING GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 04/08/2024
Certification Date: 04/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 SIR ROBERT AVE
NORTH ROYALTON OH
44133-4139
US

IV. Provider business mailing address

PO BOX 660
MENTOR OH
44061-0660
US

V. Phone/Fax

Practice location:
  • Phone: 440-390-8903
  • Fax:
Mailing address:
  • Phone: 440-230-5384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateOH

VIII. Authorized Official

Name: RICHARD ROWLETT
Title or Position: PRESIDENT
Credential: PHD
Phone: 440-390-8903