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600 Superior Ave E Ste 1300 Cleveland OH 44114-2654 | |
| (216) 373-2659 | |
| (216) 373-2659 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 600 Superior Ave E Ste 1300, Cleveland, Ohio |
| Authorized Official Name and Position | Elizabeth Brady-toomey (OWNER) |
| Authorized Official Contact | 2167443261 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
15520 Frick Ct Cleveland OH 44111-2014 Ph: (216) 373-2659 | 600 Superior Ave E Ste 1300 Cleveland OH 44114-2654 Ph: (216) 373-2659 |
| NPI Number | 1780056366 |
|---|---|
| Provider Enumeration Date | 10/22/2015 |
| Last Update Date | 10/25/2023 |
| Certification Date | 10/25/2023 |
| Medicare PECOS PAC ID | 5496193260 |
|---|---|
| Medicare Enrollment ID | O20240329002418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780056366 | NPI | - | NPPES |
| 0164527 | Medicaid | OH | |
| 0191329 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | E.100026 (Ohio) | Primary |
| Provider Name | Leslie E Valentine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043681844 PECOS PAC ID: 7012201205 Enrollment ID: I20160810002966 |
| Provider Name | Elizabeth Ann Brady-toomey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114303542 PECOS PAC ID: 6305284175 Enrollment ID: I20240416001123 |
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