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General NPI Number Information
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NPI Number | 1669624581
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE BEHAVIORAL SPECIALISTS LLC
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 10/22/2008
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Provider Practice Location Address
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Address Line | 30400 DETROIT RD STE 301
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City | WESTLAKE
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State | OH
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Zip | 44145-1872
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Country | US
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Telephone | 440-250-8868
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Fax | 440-250-8868
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Provider Business Mailing Address
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Address Line | 30400 DETROIT RD STE 301
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City | WESTLAKE
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State | OH
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Zip | 44145-1872
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Country | US
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Telephone | 440-250-8868
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Fax | 440-250-8868
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | MS. CHRISTY L SUGARMAN
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Credential | PCC, LICDC
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Telephone | 440-250-8868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E0002465 SUPV
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I0007611 S
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E0002797 SUPV
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License Number State | OH
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