Innovative Therapy Concepts, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-0500058 Issued in OH

Legal business name

INNOVATIVE THERAPY CONCEPTS, LLC

Practice address

4900 E 97TH St
Garfield HTS, OH 44125-2122

Phone

(216) 441-6767

Fax

(216) 441-6767

NPI assigned

Jul 14, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Sean L. Davis, LISW

Title

Psychotherapist/Owner

Phone

(216) 441-6767

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003814864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 E 97TH ST",
            "city": "GARFIELD HTS",
            "state": "OH",
            "postal_code": "441252122",
            "telephone_number": "216-441-6767",
            "fax_number": "216-441-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 E 97TH ST",
            "city": "GARFIELD HTS",
            "state": "OH",
            "postal_code": "441252122",
            "telephone_number": "216-441-6767",
            "fax_number": "216-441-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE THERAPY CONCEPTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/OWNER",
        "authorized_official_telephone_number": "216-441-6767",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0500058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Garfield HTS, OH
• Providers in Garfield HTS, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.