Organization
CLEVELAND SEX & INTIMACY COUNSELING
Active
Organization
CLEVELAND SEX & INTIMACY COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY A FULLER PH.D., LISW-S (CEO)
(440) 823-6010
Entity
Organization
Contact information
Practice address
3500 LORAIN AVE STE 301, CLEVELAND, OH 44113-3726
(216) 250-1607
(216) 304-6669
Mailing address
3500 LORAIN AVE STE 301, CLEVELAND, OH 44113-3726
(216) 250-1607
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083053375
—
OH
Enumeration date
10/19/2020
Last updated
09/06/2023
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