Chagrin Family Therapy Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I0600139 Issued in OH

Legal business name

CHAGRIN FAMILY THERAPY CENTER, LLC

Practice address

107 Laurel Rd
Chagrin Falls, OH 44022-3937

Phone

(440) 804-6627

Fax

(440) 543-4974

NPI assigned

Mar 4, 2008

Last updated

Mar 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anthony Marra, LISW-SNPI 1861644684

Title

Director

Phone

(440) 804-6627

Specialties & licenses 3

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anthony Marra, LISW

  • Clinical Social Worker
  • Beachwood, OH
  • NPI 1861644684
  NPD (past) Authorized official

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1629248893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 LAUREL RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "44022",
            "telephone_number": "440-804-6627",
            "fax_number": "440-543-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 LAUREL RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440223937",
            "telephone_number": "440-804-6627",
            "fax_number": "440-543-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAGRIN FAMILY THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "MARRA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "440-804-6627",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0600139",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "I0600139",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11814584",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas Charles Catania II, CTRS
• Nicole Cerny, COTA/L
• Stephanie Westbrook Cervelloni, PT
• Chagrin Falls Dental Bresciani LLC
• Chagrin Falls Suburban Volunteer Firemens Association
• Chagrin Hearing Center, LLC
• Chagrin River Counseling LLC
• Chagrin Valley Chiropractic and Acupuncture Center, LLC
• Chagrin Valley Optometrists, Inc
• Julia Chambers

• Clinical Social Worker in Chagrin Falls, OH
• Providers in Chagrin Falls, 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 Mar 4, 2008; 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.