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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