Provider Demographics
NPI:1730706151
Name:CULTIVATE COUNSELING SERVICES
Entity type:Organization
Organization Name:CULTIVATE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JHARIE
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:440-409-8433
Mailing Address - Street 1:7009 FRY RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-2514
Mailing Address - Country:US
Mailing Address - Phone:440-409-8433
Mailing Address - Fax:
Practice Address - Street 1:7009 FRY RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-2514
Practice Address - Country:US
Practice Address - Phone:440-409-8433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1760931190OtherINDIVIDUAL NPI