Provider Demographics
NPI:1669506440
Name:DBT CLEVELAND
Entity Type:Organization
Organization Name:DBT CLEVELAND
Other - Org Name:CLEVELAND CENTER FOR EATING DISORDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-765-0500
Mailing Address - Street 1:23240 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5404
Mailing Address - Country:US
Mailing Address - Phone:216-765-0500
Mailing Address - Fax:216-765-0521
Practice Address - Street 1:23240 CHAGRIN BLVD
Practice Address - Street 2:SUITE 270
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5404
Practice Address - Country:US
Practice Address - Phone:216-765-0500
Practice Address - Fax:216-765-0521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========002OtherMEDICAL MUTUAL PIN