| Organization Name: | INNOVATIVE THERAPY CONCEPTS, LLC |
| NPI Number: | 1003814864 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SEAN L. DAVIS (PSYCHOTHERAPIST/OWNER) |
| Mailing Address: | 4900 E 97th St Garfield Hts |
| State: | OH US |
| Postal Code: | 441252122 |
| Phone Number: | 2164416767 |
| Fax Number: | 2164416767 |
| NPI Enumeration Date: | 07/14/2005 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I-0500058 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |