Provider Demographics
NPI:1316796709
Name:CENTERED PLACE COUNSELING LLC
Entity type:Organization
Organization Name:CENTERED PLACE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-570-6921
Mailing Address - Street 1:3090 W MARKET ST STE 124-6
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3608
Mailing Address - Country:US
Mailing Address - Phone:234-208-6851
Mailing Address - Fax:
Practice Address - Street 1:3090 W MARKET ST STE 124-6
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3608
Practice Address - Country:US
Practice Address - Phone:234-208-6851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)