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General NPI Number Information
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NPI Number | 1962519413
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Entity Type | Individual
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Provider Name | CHARLES JAY EISINGER LPCC
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 23250 CHAGRIN BLVD STE 425 COMMERCE PARK FIVE
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City | BEACHWOOD
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State | OH
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Zip | 44122
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Country | US
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Telephone | 216-464-4243
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Fax | 216-595-8210
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Provider Business Mailing Address
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Address Line | 14170 CHILLICOTHE RD
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City | NOVELTY
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State | OH
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Zip | 44072
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Country | US
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Telephone | 440-338-4691
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | E3632
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License Number State | OH
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