NPI Code Details Logo

NPI 1033268859

NPI 1033268859 : COMPREHENSIVE BEHAVIORAL HEALTH ASSOCIATES, INC. : AUSTINTOWN, OH

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1033268859
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    COMPREHENSIVE BEHAVIORAL HEALTH ASSOCIATES, INC. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/10/2007
-----------------------------------------------------
    Last Update Date     |    09/11/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    104 JAVIT CT 
-----------------------------------------------------
    City                 |    AUSTINTOWN
-----------------------------------------------------
    State                |    OH
-----------------------------------------------------
    Zip                  |    44515-2409
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    330-797-4050
-----------------------------------------------------
    Fax                  |    330-797-4090
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    5305 SYCAMORE HILL DR 
-----------------------------------------------------
    City                 |    NEW MIDDLETOWN
-----------------------------------------------------
    State                |    OH
-----------------------------------------------------
    Zip                  |    44442-8769
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    330-542-9535
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    MEDICAL DIRECTOR AND OWNER
-----------------------------------------------------
    Name                 |    DR. KOTESWARA R. KAZA 
-----------------------------------------------------
    Credential           |    M.D.
-----------------------------------------------------
    Telephone            |    330-797-4050
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    101YP2500X
-----------------------------------------------------
    Taxonomy Name        |    Professional Counselor
-----------------------------------------------------
    License Number       |    E0002791
-----------------------------------------------------
    License Number State |    OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    101YA0400X
-----------------------------------------------------
    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
    License Number       |    965575
-----------------------------------------------------
    License Number State |    OH
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.