Organization
CLEVELAND FAMILY THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA COAN LCDCIII,PC (OWNER)
(440) 210-4763
Entity
Organization
Contact information
Practice address
23360 CHAGRIN BLVD, SUITE 102, BEACHWOOD, OH 44122-5537
(440) 210-4763
Mailing address
23360 CHAGRIN BLVD, SUITE 102, BEACHWOOD, OH 44122-5537
(440) 210-4763
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
021164
OH
101YP2500X
Professional Counselor
Primary
C0501110
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12329204
—
OH
Enumeration date
03/03/2013
Last updated
03/03/2013
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