Provider Demographics
NPI:1033219225
Name:NORTH COAST MENTAL HEALTH ASSOCIATES INC.
Entity Type:Organization
Organization Name:NORTH COAST MENTAL HEALTH ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WISHNEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-464-5330
Mailing Address - Street 1:3690 ORANGE PL
Mailing Address - Street 2:430
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4464
Mailing Address - Country:US
Mailing Address - Phone:216-464-5330
Mailing Address - Fax:
Practice Address - Street 1:3690 ORANGE PL
Practice Address - Street 2:430
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4464
Practice Address - Country:US
Practice Address - Phone:216-464-5330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0151231Medicaid
OH9277422Medicare PIN
OH9277421Medicare PIN