NPIMap

Organization Active NPI

Psycho Social Therapies,LTD

  • Clinical Social Worker
  • Beachwood, OH
National Provider Identifier
1750335261
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PSYCHO SOCIAL THERAPIES,LTD
Practice address
23366 Commerce Park Ste 100B
Beachwood, OH 44122-5801
Phone
(216) 292-2880
Fax
(866) 225-8885
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Authorized official

Name
Mr. Max Compton
Title
President
Phone
(216) 292-2880

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

23366 Commerce Park Ste 100B
Beachwood, OH 44122-5801

Mailing address

23366 Commerce Park Ste 100B
Beachwood, OH 44122-5801
Phone (216) 292-2880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051208000882 OH Part B Supplier - Clinic/Group Practice 9234165424 Receives reassigned benefits from 82 practitioners
1 other NPI on this enrollment

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gillette Nursing HomeWarren, OH, CCN 366129 Skilled nursing facility Limited Partnership Interest
Adp of the SNF		 Jan 1, 2020
Jan 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 160

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 160

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1750335261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23366 COMMERCE PARK STE 100B",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225801",
            "telephone_number": "216-292-2880",
            "fax_number": "866-225-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23366 COMMERCE PARK STE 100B",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225801",
            "telephone_number": "216-292-2880",
            "fax_number": "866-225-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHO SOCIAL THERAPIES,LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "COMPTON",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-292-2880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.