Provider Demographics
NPI:1588814909
Name:ART OF FAMILY COUNSELING AND EDUCATIONAL SERVICES
Entity Type:Organization
Organization Name:ART OF FAMILY COUNSELING AND EDUCATIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VEDA
Authorized Official - Middle Name:VALDEZ
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:IMFT
Authorized Official - Phone:216-926-8879
Mailing Address - Street 1:PO BOX 21340
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-0340
Mailing Address - Country:US
Mailing Address - Phone:216-926-8879
Mailing Address - Fax:216-291-3484
Practice Address - Street 1:1512 S GREEN RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4042
Practice Address - Country:US
Practice Address - Phone:216-926-8879
Practice Address - Fax:216-291-3484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF114106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2794874Medicaid