Provider Demographics
NPI:1750335261
Name:PSYCHO SOCIAL THERAPIES,LTD
Entity type:Organization
Organization Name:PSYCHO SOCIAL THERAPIES,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:COMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-292-2880
Mailing Address - Street 1:23366 COMMERCE PARK STE 100B
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5801
Mailing Address - Country:US
Mailing Address - Phone:216-292-2880
Mailing Address - Fax:866-225-8885
Practice Address - Street 1:23366 COMMERCE PARK STE 100B
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5801
Practice Address - Country:US
Practice Address - Phone:216-292-2880
Practice Address - Fax:866-225-8885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9358571Medicare ID - Type Unspecified
NJ092080Medicare ID - Type Unspecified