Foss, Richard Jack

Foss, Richard Jack is an sole proprietor health care provider with primary practice located at 7232 Justin Way , Mentor OH 44060-4881. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is his primary health care specialty. Foss, Richard Jack can be contacted via phone (440) 578-8200.

Contact Information

Primary practice address
7232 Justin Way Mentor OH 44060-4881
Phone: (440) 578-8200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Other Service Providers / Peer Specialist 175T00000X 000240 Ohio
Behavioral Health & Social Service Providers / Social Worker 104100000X S.0029313 Ohio

Profile Details

NPI number 1205340718
LBN Legal business name Foss, Richard Jack
Credentials LSW, CPRS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 20th, 2017
Last updated Aug 17th, 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 1205340718 NPPES
Ohio MEDICAID 0278787

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