| Enchanted Cottage Therapy LLC | |
|
415 Front St Berea OH 44017-1716 | |
| (315) 383-3225 | |
| Not Available |
| Full Name | Enchanted Cottage Therapy LLC |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 415 Front St, Berea, Ohio |
| Authorized Official Name and Position | Lisa Sullivan (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 4404530754 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enchanted Cottage Therapy LLC 415 Front St Berea OH 44017-1716 Ph: (315) 383-3225 | Enchanted Cottage Therapy LLC 415 Front St Berea OH 44017-1716 Ph: (315) 383-3225 |
| NPI Number | 1265131163 |
|---|---|
| Provider Enumeration Date | 02/28/2023 |
| Last Update Date | 02/28/2023 |
| Certification Date | 02/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265131163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (NU) | Primary |
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