Healthcare Provider Details

I. General information

NPI: 1053410613
Provider Name (Legal Business Name): THE HANNA PERKINS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19910 MALVERN RD
SHAKER HEIGHTS OH
44122-2823
US

IV. Provider business mailing address

19910 MALVERN RD
SHAKER HEIGHTS OH
44122-2823
US

V. Phone/Fax

Practice location:
  • Phone: 216-929-0200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2831
License Number StateOH

VIII. Authorized Official

Name: DR. THOMAS BARRETT
Title or Position: DIRECTOR
Credential: PH.D.
Phone: 216-929-0200