Provider Demographics
NPI:1376185157
Name:CONVERSATIONS FOR CHANGE COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:CONVERSATIONS FOR CHANGE COUNSELING SERVICES, INC.
Other - Org Name:CONVERSATIONS FOR CHANGE COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SACCO
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:630-946-4045
Mailing Address - Street 1:29882 ADAMS LN
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-6423
Mailing Address - Country:US
Mailing Address - Phone:630-946-4045
Mailing Address - Fax:
Practice Address - Street 1:31674 CENTER RIDGE RD STE 102
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-2401
Practice Address - Country:US
Practice Address - Phone:440-484-3229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-12
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty