Provider Demographics
NPI:1801114087
Name:HEARTH CONSULTANTS LLC
Entity type:Organization
Organization Name:HEARTH CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GLEISSER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:216-533-1391
Mailing Address - Street 1:29525 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4644
Mailing Address - Country:US
Mailing Address - Phone:216-533-1391
Mailing Address - Fax:216-283-9335
Practice Address - Street 1:29525 CHAGRIN BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4644
Practice Address - Country:US
Practice Address - Phone:216-533-1391
Practice Address - Fax:216-283-9335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI19841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9390021Medicare PIN