LAKEFRONT PSYCHOLOGY (NPI# 1740790252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740790252 |
| Entity Type | Organization |
| Organization Name | LAKEFRONT PSYCHOLOGY |
| Practice Address |
1991 Crocker Rd Ste 604 Westlake OH 44145-6969 |
| Mailing Address |
31729 Tradewinds Dr Avon Lake OH 44012-2916 |
| Practice Telephone | 2168709816 |
| Mailing Telephone | 2168709814 |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2017-10-10 |
| Authorized Official Name | DR. SUZANNE JEAN SMITH (CLINICAL PSYCHOLOGIST/OWNER) |
| Authorized Official Telephone | 2168709816 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
6103 | OH | Ambulatory Health Care Facilities |
| Street Address |
1991 CROCKER RD STE 604 |
| City | WESTLAKE |
| State | OH |
| Zip Code | 44145-6969 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1700425030 | The Family Dentist of Westlake Jonathan J Klineman Dds Inc | Dentist | 26600 Detroit Rd Suite 230, Westlake, OH 44145 | 2020-01-03 |
| 1033772421 | Holding Space, LLC | Social Worker | 26404 Center Ridge Rd Building A1 Ste A7, Westlake, OH 44145 | 2019-04-21 |
| 1326532508 | Integrative Pain Care LLC | Durable Medical Equipment & Medical Supplies | 25200 Center Ridge Rd, Ste 3300, Westlake, OH 44145 | 2018-06-20 |
| 1841783990 | Wendy Lynn Wheeler | Counselor | 28263 Center Ridge Rd, Westlake, OH 44145 | 2018-06-13 |
| 1326557836 | Tiffany Manrodt | Social Worker | 24500 Center Ridge Road Bldg 4, #120, Westlake, OH 44145 | 2017-09-27 |
| 1639620792 | Stacy Ryan | Speech-Language Pathologist | 3057 Holly Lane, Westlake, OH 44145 | 2016-10-24 |
| 1790238954 | Kathleen Hanigosky | Pharmacist | 27175 Center Ridge Rd., Westlake, OH 44145 | 2016-07-25 |
| 1780073155 | Prominent Healthcare, Inc. | Community/Behavioral Health | 24650 Westlake Center Ridge Road, Westlake, OH 44145 | 2015-01-22 |
| 1902225022 | Amanda Brooke Abernathy | Physical Therapist | 850 Columbia Road, Suite #110, Westlake, OH 44145 | 2014-04-16 |
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| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801053111 | Dr. Manuel E. Gordillo Inc. | Clinic/Center | 30400 Detroit Rd, Suite 304, Westlake, OH 44145-1872 | 2008-05-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.