BEECH BROOK (NPI# 1093816209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093816209 |
| Entity Type | Organization |
| Organization Name | BEECH BROOK |
| Practice Address |
3737 Lander Road Pepper Pike OH 44124 |
| Mailing Address |
3737 Lander Rd Pepper Pike OH 44124-5712 |
| Practice Telephone | 2168312255 |
| Practice Fax Number | 2168310436 |
| Mailing Telephone | 2168312255 |
| Mailing Fax Number | 2168310436 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2008-12-31 |
| Authorized Official Name | DEBRA REX (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2168312255 |
| Authorized Official Credential | MED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 12773 | OH | Agencies |
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
208 | OH | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | ODADAS PROVIDER CERTIFICATION | 12773 | 01 |
| OH | 0268768 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437399474 | Beech Brook | Clinic/Center | 11801 Buckeye Rd, Cleveland, OH 44120-2620 | 2009-03-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | BEECH BROOK HUNT CLUB INCORPORATED | Po Box 602, Covington, Virginia 24426 |
| Street Address |
3737 LANDER ROAD |
| City | PEPPER PIKE |
| State | OH |
| Zip Code | 44124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154897833 | Allyson Krueger | Social Worker | 3737 Lander Road, Pepper Pike, OH 44124 | 2018-10-19 |
| 1285033902 | Jennifer M. Ostrowski | Social Worker | 3737 Lander Road, Pepper Pike, OH 44124 | 2014-08-19 |
| 1174833651 | Karen D Suggs | Social Worker | 3737 Lander Road, Pepper Pike, OH 44124-5712 | 2010-10-18 |
| 1992015473 | Marcie L Riley | Social Worker | 3737 Lander Road, Pepper Pike, OH 44124-5712 | 2010-10-18 |
| 1598075137 | Pauline Congeni | Social Worker | 3737 Lander Road, Pepper Pike, OH 44124-5712 | 2010-10-18 |
| 1982914537 | Dawn Brodnick | Social Worker | 3737 Lander Road, Pepper Pike, OH 44124-5712 | 2010-10-18 |
| 1811207392 | Jacqueline E Jones | Social Worker | 3737 Lander Road, Pepper Pike, OH 44124-5712 | 2010-10-18 |
| 1033429675 | Tracy M Broa-turner | Counselor | 3737 Lander Road, Pepper Pike, OH 44124-5712 | 2010-10-18 |
| 1720398365 | Jennifer L Vasquez | Social Worker | 3737 Lander Road, Pepper Pike, OH 44124-5712 | 2010-10-18 |
| 1003126582 | Claudette M Williams | Social Worker | 3737 Lander Road, Pepper Pike, OH 44124-5712 | 2010-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104470509 | Marian Rae Barton | Physician Assistant | 6092 Mayfield Rd, Mayfield Heights, OH 44124 | 2019-07-25 |
| 1831669860 | Tameka D. Weaver | Home Health Aide | 1408 Golden Gate Blvd, Mayfield Hts, OH 44124 | 2018-12-03 |
| 1508371238 | Jamila Shafawn Hardy | Counselor | 1320 Washington Blvd, Cleveland, OH 44124 | 2017-12-04 |
| 1134664899 | Sergio Watson | Licensed Practical Nurse | 1131 Irene Rd, Lyndhurst, OH 44124 | 2017-01-04 |
| 1164894424 | Carrie Lynn Rodick | Registered Nurse | 1212 Blanchester, Lyndhurst, OH 44124 | 2015-10-27 |
| 1205205804 | Mary Rose Moore | Nurse Practitioner | 1443 Richmond Road, Lyndhurst, OH 44124 | 2015-09-24 |
| 1154717551 | Hongfei Di | Family Medicine | 5187 Mayfield Rd Ste 102, Lyndhurst, OH 44124 | 2015-04-13 |
| 1558753376 | Taj Amjad Khan | Pediatrics | 32810 Creekside Drive, Pepper Pike, OH 44124 | 2015-03-03 |
| 1902297195 | Marcellus Gliha | Hearing Instrument Specialist | 1438 S.o.m. Center Rd, #101, Mayfield Heights, OH 44124 | 2015-02-10 |
| 1194122051 | Doug Blecher | Counselor | 5512 Kilbourne Dr, Cleveland, OH 44124 | 2014-11-20 |
| Find all providers in zip 44124 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295340511 | Alliance Therapeutic Practices, LLC | Clinic/Center | 822 Delta Ave Ste 1, Cincinnati, OH 45226-1256 | 2020-09-14 |
| 1922610898 | Alyssa Banks | Clinic/Center | 915 N Erie St, Toledo, OH 43604-1605 | 2020-08-20 |
| 1154931574 | Compassionate Connections for Children LLC | Clinic/Center | 7060 Copperglow Ct, Cincinnati, OH 45244-3649 | 2020-08-01 |
| 1568085876 | Laura Irene Davis | Clinic/Center | 2020 Brice Rd Ste 110, Reynoldsburg, OH 43068-3448 | 2020-05-20 |
| 1407481021 | Counseling On Purpose, LLC | Clinic/Center | 1350 5th Ave Ste 310, Youngstown, OH 44504-1765 | 2020-03-04 |
| 1639710361 | Soaring On Success, LLC | Clinic/Center | 2146 N 13th St, Toledo, OH 43620-1909 | 2019-10-03 |
| 1366928863 | Fairmount Mental Wellness LLC | Clinic/Center | 2460 Fairmount Blvd Ste 317, Cleveland Heights, OH 44106-3164 | 2018-07-17 |
| 1891286548 | Robin's House | Clinic/Center | 326 Bierce Ave, Dayton, OH 45403-2657 | 2018-05-29 |
| 1558869206 | Pathways Behavioral Healthcare, Inc. | Clinic/Center | 333 S Main St Ste 105, Akron, OH 44308-1210 | 2018-01-29 |
| 1508379314 | Trumbull County Children Services | Clinic/Center | 2282 Reeves Rd Ne, Warren, OH 44483-4300 | 2017-11-15 |
| Find all providers with the same taxonomy | ||||
| City | PEPPER PIKE |
| Zip Code | 44124 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.