Provider Demographics
NPI:1760114201
Name:ENGAGE PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:ENGAGE PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPCC
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:COOKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:419-318-8853
Mailing Address - Street 1:1638 WILDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-4025
Mailing Address - Country:US
Mailing Address - Phone:740-817-4807
Mailing Address - Fax:
Practice Address - Street 1:1351 S REYNOLDS RD STE B
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-7411
Practice Address - Country:US
Practice Address - Phone:419-318-8853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty