| North Coast Family Foundation | |
|
6902 Pearl Rd Ste 502 Middleburg Heights OH 44130-3621 | |
| (440) 842-6867 | |
| (440) 842-8914 |
| Full Name | North Coast Family Foundation |
|---|---|
| Speciality | Psychologist |
| Location | 6902 Pearl Rd Ste 502, Middleburg Heights, Ohio |
| Authorized Official Name and Position | Charles F Misja (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4408426867 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Coast Family Foundation 6902 Pearl Rd Ste 502 Middleburg Heights OH 44130-3621 Ph: (440) 842-6867 | North Coast Family Foundation 6902 Pearl Rd Ste 502 Middleburg Heights OH 44130-3621 Ph: (440) 842-6867 |
| NPI Number | 1013959238 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 04/08/2024 |
| Certification Date | 04/08/2024 |
| Medicare PECOS PAC ID | 9739191172 |
|---|---|
| Medicare Enrollment ID | O20060628000366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013959238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Michael C Misja |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104869916 PECOS PAC ID: 0345409728 Enrollment ID: I20120302000599 |
| Provider Name | Charles F Misja |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851337679 PECOS PAC ID: 0648282087 Enrollment ID: I20120315000167 |
| Provider Name | Vetrice Kotek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518581792 PECOS PAC ID: 6103213897 Enrollment ID: I20220427002411 |
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