| Community Behavioral Health Center | |
|
3690 Orange Pl Ste 320 Beachwood OH 44122-4432 | |
| (216) 831-1494 | |
| (216) 831-9931 |
| Full Name | Community Behavioral Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3690 Orange Pl Ste 320, Beachwood, Ohio |
| Authorized Official Name and Position | Ritu Chattree (CEO) |
| Authorized Official Contact | 2168311494 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Behavioral Health Center 3690 Orange Pl Ste 320 Beachwood OH 44122-4432 Ph: (216) 831-1494 | Community Behavioral Health Center 3690 Orange Pl Ste 320 Beachwood OH 44122-4432 Ph: (216) 831-1494 |
| NPI Number | 1962448654 |
|---|---|
| Provider Enumeration Date | 06/21/2006 |
| Last Update Date | 02/08/2023 |
| Certification Date | 02/08/2023 |
| Medicare PECOS PAC ID | 5799682605 |
|---|---|
| Medicare Enrollment ID | O20031218000163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962448654 | NPI | - | NPPES |
| 2452813 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 0321 (Ohio) | Primary |
| Provider Name | Kuldeep Vaghela |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255544037 PECOS PAC ID: 5092857367 Enrollment ID: I20111209000435 |
| Provider Name | Irina Grinberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548469919 PECOS PAC ID: 4789955493 Enrollment ID: I20170728002705 |
| Provider Name | Gabriel P Jeu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588272033 PECOS PAC ID: 6709290125 Enrollment ID: I20210126003539 |
| Provider Name | Lauren D'lee Dicks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518343334 PECOS PAC ID: 2466860655 Enrollment ID: I20210428002343 |
| Provider Name | Olena A Stetsura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417627985 PECOS PAC ID: 4486049418 Enrollment ID: I20220309002545 |
| Provider Name | Carter Dodeci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104519222 PECOS PAC ID: 9234597006 Enrollment ID: I20230627001033 |
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