Provider Demographics
NPI:1659522423
Name:BEHAVIORAL HEALTH SERVICES OF GREATER CLEVELAND
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH SERVICES OF GREATER CLEVELAND
Other - Org Name:GIFT COUNSELING SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:866-466-9591
Mailing Address - Street 1:20525 CENTER RIDGE RD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3437
Mailing Address - Country:US
Mailing Address - Phone:866-466-9591
Mailing Address - Fax:216-712-6313
Practice Address - Street 1:20525 CENTER RIDGE RD
Practice Address - Street 2:SUITE 403
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3437
Practice Address - Country:US
Practice Address - Phone:866-466-9591
Practice Address - Fax:216-712-6313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YA0400X, 1041C0700X
OH6608103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty