Provider Demographics
NPI:1477720944
Name:PSYCHOLOGICAL & BEHAVIORAL CONSULTANTS
Entity Type:Organization
Organization Name:PSYCHOLOGICAL & BEHAVIORAL CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:216-255-9450
Mailing Address - Street 1:1589 WAGAR AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3640
Mailing Address - Country:US
Mailing Address - Phone:216-255-9450
Mailing Address - Fax:
Practice Address - Street 1:25111 COUNTRY CLUB BLVD STE 290
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-5330
Practice Address - Country:US
Practice Address - Phone:216-831-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE 0003976251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health