Provider Demographics
NPI:1679059760
Name:RINDSBERG, JEFFREY (PSYD, ABPP)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:RINDSBERG
Suffix:
Gender:M
Credentials:PSYD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25200 CHAGRIN BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5681
Mailing Address - Country:US
Mailing Address - Phone:216-245-6311
Mailing Address - Fax:888-567-7553
Practice Address - Street 1:25200 CHAGRIN BLVD STE 105
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5681
Practice Address - Country:US
Practice Address - Phone:216-245-6311
Practice Address - Fax:888-567-7553
Is Sole Proprietor?:No
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5982103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical