Individual
DOUGLAS BOOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
23412 COMMERCE PARK, BEACHWOOD, OH 44122-5813
(216) 400-6640
Mailing address
23412 COMMERCE PARK, BEACHWOOD, OH 44122-5813
(216) 400-6640
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C.1801578
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.161467
OH
101YP2500X
Professional Counselor
Primary
E.2606680
OH
Other
Enumeration date
12/08/2017
Last updated
03/09/2026
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