Provider Demographics
NPI:1386053114
Name:COMPREHENSIVE PSYCHOLOGICAL COUNSELING,INC
Entity type:Organization
Organization Name:COMPREHENSIVE PSYCHOLOGICAL COUNSELING,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:440-725-9801
Mailing Address - Street 1:7575 FREDLE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CONCORD TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-9413
Mailing Address - Country:US
Mailing Address - Phone:440-725-9801
Mailing Address - Fax:440-358-0058
Practice Address - Street 1:7575 FREDLE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CONCORD TWP
Practice Address - State:OH
Practice Address - Zip Code:44077-9413
Practice Address - Country:US
Practice Address - Phone:440-725-9801
Practice Address - Fax:440-358-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00072511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherTIN