Provider Demographics
NPI:1205172566
Name:BOZEMAN, CELESTE A (MED,NBCC, LPCC)
Entity type:Individual
Prefix:MS
First Name:CELESTE
Middle Name:A
Last Name:BOZEMAN
Suffix:
Gender:F
Credentials:MED,NBCC, 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 23394
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-0394
Mailing Address - Country:US
Mailing Address - Phone:216-533-3019
Mailing Address - Fax:
Practice Address - Street 1:3401 ENTERPRISE PKWY STE 340-774
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7341
Practice Address - Country:US
Practice Address - Phone:440-774-1800
Practice Address - Fax:216-518-2200
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.150007101YA0400X, 101YP2500X
OHC0700472101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)