Provider Demographics
NPI:1669624581
Name:COMPREHENSIVE BEHAVIORAL SPECIALISTS LLC
Entity type:Organization
Organization Name:COMPREHENSIVE BEHAVIORAL SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SUGARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PCC, LICDC
Authorized Official - Phone:440-250-8868
Mailing Address - Street 1:30400 DETROIT RD
Mailing Address - Street 2:STE 301
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1872
Mailing Address - Country:US
Mailing Address - Phone:440-250-8868
Mailing Address - Fax:440-250-8868
Practice Address - Street 1:30400 DETROIT RD
Practice Address - Street 2:STE 301
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1872
Practice Address - Country:US
Practice Address - Phone:440-250-8868
Practice Address - Fax:440-250-8868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002465 SUPV101YP2500X
OHI0007611 S1041C0700X
OHE0002797 SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty