Provider Demographics
NPI:1053661538
Name:ACCESS PSYCHO-SOCIAL SERVICES INC.
Entity Type:Organization
Organization Name:ACCESS PSYCHO-SOCIAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:DCSW, MSSA, LISW-S,
Authorized Official - Phone:440-954-4975
Mailing Address - Street 1:27601 MILLS AVENUE
Mailing Address - Street 2:UNIT J
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-3075
Mailing Address - Country:US
Mailing Address - Phone:440-954-4975
Mailing Address - Fax:
Practice Address - Street 1:7784 REYNOLDS PLACE
Practice Address - Street 2:SUITE 213
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5321
Practice Address - Country:US
Practice Address - Phone:440-954-4975
Practice Address - Fax:216-731-4993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0002706251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0002706OtherLISW-S
OH0815292Medicaid