Benore, Ethan R

Benore, Ethan R is an individual health care provider with primary practice located at 2801 Mlk Jr Dr , Cleveland OH 44104-3815. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is his primary health care specialty. Benore, Ethan R can be contacted via phone (216) 448-6253.

Contact Information

Primary practice address
2801 Mlk Jr Dr Cleveland OH 44104-3815
Phone: (216) 448-6253
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 6154 Ohio
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 6154 Ohio

Profile Details

NPI number 1629002951
LBN Legal business name Benore, Ethan R
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Nov 12th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629002951 NPPES
Ohio MEDICAID 2606326

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