MEDICARE: OHIO PSYCHIATRY & COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	103T00000X	Psychologist
3	104100000X	Social Worker
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
5	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1356275382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO PSYCHIATRY & COUNSELING LLC

Provider Business Mailing Address
First Line	:	800 ENTERPRISE DR STE 214
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-4218
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 E 45TH ST STE 511
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44127-1088
Country	:	US
Telephone Number	:	312-600-5061
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WAJAHAT MACCI
Credential	:
Telephone Number	:	312-600-5061

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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