Organization
NORTHEAST OHIO PSYCHOLOGICAL CONSULTANTS, LTD.
Active
Organization
NORTHEAST OHIO PSYCHOLOGICAL CONSULTANTS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD JAMES LEWELLYN PH.D. (PRESIDENT)
(330) 758-3819
Entity
Organization
Contact information
Practice address
839 SOUTHWESTERN RUN, POLAND, OH 44514-4688
(330) 758-3819
(330) 758-4965
Mailing address
839 SOUTHWESTERN RUN, POLAND, OH 44514-4688
(330) 758-3819
(330) 758-4965
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4295
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000248739
ANTHEM #
OH
01
—
11389741
CAQH PROVIDER #
OH
01
—
162919
GM/PACKARD/CIGNA #
OH
01
—
227276000
MAGELLAN MIS #
OH
01
—
334924
MHS #
OH
01
—
4295
OHIO LICENSE #
OH
01
—
CP03076
MEDICARE GROUP
OH
Enumeration date
05/17/2006
Last updated
05/03/2017
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