Provider Demographics
NPI:1194200352
Name:COMPREHENSIVE PSYCHOLOGICAL HEALTH
Entity Type:Organization
Organization Name:COMPREHENSIVE PSYCHOLOGICAL HEALTH
Other - Org Name:IMPACT COUNSELING SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPCC
Authorized Official - Phone:216-313-8929
Mailing Address - Street 1:4630 ST JOSEPH WAY
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-3764
Mailing Address - Country:US
Mailing Address - Phone:216-313-8929
Mailing Address - Fax:
Practice Address - Street 1:24500 CENTER RIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5602
Practice Address - Country:US
Practice Address - Phone:440-455-1511
Practice Address - Fax:440-455-9500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty