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Organization

RAVENWOOD MENTAL HEALTH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICKI CLARK LPCC-S (CEO)
(440) 285-2170
Entity
Organization

Contact information

Practice address
12557 RAVENWOOD DR, CHARDON, OH 44024
(440) 285-3568
(440) 285-4552
Mailing address
12557 RAVENWOOD DRIVE, CHARDON, OH 44024
(440) 285-2170
(440) 285-2207

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
OH
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0576916
OH
Enumeration date
07/10/2006
Last updated
03/21/2014
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