Provider Demographics
NPI:1417445297
Name:IASC COUNSELING SERVICES INC
Entity Type:Organization
Organization Name:IASC COUNSELING SERVICES INC
Other - Org Name:IASC COUNSELING SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ISABEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANCHEZ CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MSSA, LISW, MPA
Authorized Official - Phone:440-490-6680
Mailing Address - Street 1:8004 WILSON MILLS RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-1853
Mailing Address - Country:US
Mailing Address - Phone:216-577-8292
Mailing Address - Fax:
Practice Address - Street 1:8251 MAYFIELD RD STE 202
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-2567
Practice Address - Country:US
Practice Address - Phone:216-577-8292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1600358251S00000X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0209035Medicaid