Provider Demographics
NPI:1962519413
Name:EISINGER, CHARLES JAY (LPCC)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:JAY
Last Name:EISINGER
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14170 CHILLICOTHE RD
Mailing Address - Street 2:
Mailing Address - City:NOVELTY
Mailing Address - State:OH
Mailing Address - Zip Code:44072
Mailing Address - Country:US
Mailing Address - Phone:440-338-4691
Mailing Address - Fax:
Practice Address - Street 1:23250 CHAGRIN BLVD
Practice Address - Street 2:STE 425 COMMERCE PARK FIVE
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-464-4243
Practice Address - Fax:216-595-8210
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE36321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical