MEDICARE: THE METAMORPHOSIS GROUP, LTD

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1780760348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE METAMORPHOSIS GROUP, LTD

Provider Business Mailing Address
First Line	:	29525 CHAGRIN BLVD
Second Line	:	SUITE 309
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4644
Country	:	US
Telephone Number	:	216-464-5592
Fax Number	:	216-464-5593

Provider Business Practice Location Address
First Line	:	29525 CHAGRIN BLVD
Second Line	:	SUITE 309
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4644
Country	:	US
Telephone Number	:	216-464-5592
Fax Number	:	216-464-5593

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	DR. MATTHEW JOSEPH HILFER
Credential	:	PHD
Telephone Number	:	216-464-5592

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	08/22/2020

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