Organization
CHAGRIN FAMILY THERAPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY MARRA LISW-S (DIRECTOR)
(440) 804-6627
Entity
Organization
Contact information
Practice address
107 LAUREL RD, CHAGRIN FALLS, OH 44022-3937
(440) 804-6627
(440) 543-4974
Mailing address
107 LAUREL RD, CHAGRIN FALLS, OH 44022
(440) 804-6627
(440) 543-4974
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I0600139
OH
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
I0600139
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11814584
CAQH
OH
Enumeration date
03/04/2008
Last updated
03/04/2008
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