Organization
CASS - MIND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN ALLEN MCDONALD (VP & DIRECTOR)
(330) 687-3086
Entity
Organization
Contact information
Practice address
405 MOXAHALA AVE, ZANESVILLE, OH 43701-4915
(330) 687-3086
Mailing address
4467 SAINT GERMAIN BLVD, WARRENSVILLE HEIGHTS, OH 44128-6202
(330) 687-3086
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
221700000X
Art Therapist
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225A00000X
Music Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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