Provider Demographics
NPI:1245945864
Name:HEAD & HEART THERAPEUTIC SOLUTIONS LLC
Entity type:Organization
Organization Name:HEAD & HEART THERAPEUTIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAZMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANNER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:216-202-0685
Mailing Address - Street 1:99 W SAINT CLAIR AVE APT 1606
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-1536
Mailing Address - Country:US
Mailing Address - Phone:330-814-4277
Mailing Address - Fax:
Practice Address - Street 1:99 W SAINT CLAIR AVE APT 1606
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-1536
Practice Address - Country:US
Practice Address - Phone:330-814-4277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0268082Medicaid