Provider Demographics
NPI:1659802122
Name:WESTSIDE BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:WESTSIDE BEHAVIORAL HEALTH, LLC
Other - Org Name:ERIN COOPER, PHD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:859-512-9921
Mailing Address - Street 1:2660 GLENMORE DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-3928
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24600 CENTER RIDGE RD
Practice Address - Street 2:BUILDING 3, SUITE 130
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5638
Practice Address - Country:US
Practice Address - Phone:216-295-5624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-25
Last Update Date:2017-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7303103T00000X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty