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NPI Code Detail

MEDICARE: PSYCHO SOCIAL THERAPIES,LTD

MEDICARE: PSYCHO SOCIAL THERAPIES,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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1902462906
Entity Type Code : Organization
Provider Name (Legal Business Name) : PSYCHO SOCIAL THERAPIES,LTD
Provider Business Mailing Address
First Line : 23366 COMMERCE PARK STE 100B
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5801
Country : US
Telephone Number : 216-292-2880
Fax Number : 216-446-6030
Provider Business Practice Location Address
First Line : 23366 COMMERCE PARK STE 100B
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5801
Country : US
Telephone Number : 216-292-2880
Fax Number : 216-446-6030
Authorized Official
Title or Position : PRESIDENT
Name : MORDECHAI COMPTON
Credential :
Telephone Number : 216-292-2880
Provider Enumeration Date : 05/15/2019
Last Update Date : 12/06/2023

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1336721489 — CORINNE O'CONNOR LSW
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1578291266 — KAREN BARNES
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1033828884 — MRS. LISA KAY BALLINGER
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Directions to “PSYCHO SOCIAL THERAPIES,LTD ” Practice Location

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