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General NPI Number Information
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NPI Number | 1457201956
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Entity Type | Organization
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Legal Business Name | STEADFAST HEALTH PROFESSIONAL SERVICES OF OHIO INC
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 11201 SHAKER BLVD STE 106
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City | CLEVELAND
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State | OH
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Zip | 44104-3833
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Country | US
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Telephone | 866-935-0936
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Fax |
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Provider Business Mailing Address
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Address Line | 11201 SHAKER BLVD STE 106
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City | CLEVELAND
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State | OH
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Zip | 44104-3833
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Country | US
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Telephone | 866-935-0936
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Fax |
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Authorized Official
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Title or Position | COO
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Name | DAVIS STEPHEN
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Credential | MD
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Telephone | 615-987-5512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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