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General NPI Number Information
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NPI Number | 1801291752
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Entity Type | Organization
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Legal Business Name | ASSOCIATED CONSULTANTS, INC.
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Dates
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Enumeration Date | 11/04/2014
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 23360 CHAGRIN BLVD SUITE 106
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City | BEACHWOOD
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State | OH
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Zip | 44122-5537
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Country | US
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Telephone | 440-523-0088
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Fax | 440-349-0404
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Provider Business Mailing Address
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Address Line | 23360 CHAGRIN BLVD SUITE 106
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City | BEACHWOOD
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State | OH
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Zip | 44122-5537
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Country | US
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Telephone | 440-523-0088
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Fax | 440-349-0404
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | DR. REGINALD C BLUE
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Credential |
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Telephone | 440-523-0088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2166
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License Number State | OH
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