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Individual

DR. JAMIE B. LICHSTEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
24100 CHAGRIN BLVD, SUITE 400, BEACHWOOD, OH 44122-5535
(216) 831-1040
(216) 831-2667
Mailing address
25700 SCIENCE PARK DRIVE, SUITE 200, LANDMARK CENTRE., BEACHWOOD, OH 44122-5535
(216) 831-1040
(216) 831-2667

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5968
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1525589732001
MEDICAL MUTUAL
OH
Enumeration date
01/16/2007
Last updated
11/09/2016
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