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NPI Code Detail

MEDICARE: PSYCHOLOGICAL & BEHAVIORAL CONSULTANTS

MEDICARE: PSYCHOLOGICAL & BEHAVIORAL CONSULTANTS
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyE 0003976OH

General Provider Information

NPI Number : 1477720944
Entity Type Code : Organization
Provider Name (Legal Business Name) : PSYCHOLOGICAL & BEHAVIORAL CONSULTANTS
Provider Business Mailing Address
First Line : 1589 WAGAR AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-3640
Country : US
Telephone Number : 216-255-9450
Fax Number :
Provider Business Practice Location Address
First Line : 25111 COUNTRY CLUB BLVD STE 290
Second Line :
City : NORTH OLMSTED
State : OH
Zip : 44070-5330
Country : US
Telephone Number : 216-831-2500
Fax Number :
Authorized Official
Title or Position : LICENSED CLINICAL COUNSELOR
Name : MRS. NANCY ANN KLEIN
Credential : LPCC
Telephone Number : 216-255-9450
Provider Enumeration Date : 05/13/2008
Last Update Date : 05/13/2008

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Directions to “PSYCHOLOGICAL & BEHAVIORAL CONSULTANTS ” Practice Location

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