Provider Demographics
NPI:1548766512
Name:DRAKE COUNSELING GROUP
Entity Type:Organization
Organization Name:DRAKE COUNSELING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MISIT
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:216-588-1313
Mailing Address - Street 1:540 E 105TH ST STE 208
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-1394
Mailing Address - Country:US
Mailing Address - Phone:216-588-1313
Mailing Address - Fax:216-588-1428
Practice Address - Street 1:540 E 105TH ST STE 208
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-1394
Practice Address - Country:US
Practice Address - Phone:216-588-1313
Practice Address - Fax:216-588-1428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0007996101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty