Provider Demographics
NPI:1942347661
Name:STRONGSVILLE PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:STRONGSVILLE PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAHULSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-234-9955
Mailing Address - Street 1:14843 W SPRAGUE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-1754
Mailing Address - Country:US
Mailing Address - Phone:440-234-9955
Mailing Address - Fax:440-234-5994
Practice Address - Street 1:14843 W SPRAGUE RD
Practice Address - Street 2:SUITE A
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-1754
Practice Address - Country:US
Practice Address - Phone:440-234-9955
Practice Address - Fax:440-234-5994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
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
OHST9282511Medicare ID - Type Unspecified