Provider Demographics
NPI:1932267168
Name:GREATER CLEVELAND PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:GREATER CLEVELAND PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SEGGIO
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:440-263-7470
Mailing Address - Street 1:10900 PEARL RD
Mailing Address - Street 2:SUITE C-3
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-3349
Mailing Address - Country:US
Mailing Address - Phone:440-263-7470
Mailing Address - Fax:440-886-1555
Practice Address - Street 1:10900 PEARL RD
Practice Address - Street 2:SUITE C-3
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-3349
Practice Address - Country:US
Practice Address - Phone:440-263-7470
Practice Address - Fax:440-886-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1922036839OtherNPI-SEGGIO
OH73069800OtherMAGELLAN
OH1922036839OtherNPI-SEGGIO
OH=========OtherTIN
OHDD9733Medicare ID - Type UnspecifiedRR MEDICARE