Provider Demographics
NPI:1962483487
Name:BOOKATZ, MADLYN F (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:MADLYN
Middle Name:F
Last Name:BOOKATZ
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24242
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44124-0242
Mailing Address - Country:US
Mailing Address - Phone:216-839-2273
Mailing Address - Fax:216-836-2273
Practice Address - Street 1:28790 CHAGRIN BLVD
Practice Address - Street 2:SUITE 260
Practice Address - City:PEPPER PIKE
Practice Address - State:OH
Practice Address - Zip Code:44122-4642
Practice Address - Country:US
Practice Address - Phone:216-839-2273
Practice Address - Fax:216-896-0735
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0001624101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health