Provider Demographics
NPI:1861065252
Name:TRANSCEND MENTAL BEHAVIOR GROUP, LLC
Entity type:Organization
Organization Name:TRANSCEND MENTAL BEHAVIOR GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LANAE
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:CDCA
Authorized Official - Phone:216-340-7484
Mailing Address - Street 1:1414 S GREEN RD STE 307
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3976
Mailing Address - Country:US
Mailing Address - Phone:216-340-7484
Mailing Address - Fax:
Practice Address - Street 1:1414 S GREEN RD STE 307
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3976
Practice Address - Country:US
Practice Address - Phone:216-340-7484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty