| Jay H. Berk, Ph.d., Inc. | |
|
23293 Commerce Park Beachwood OH 44122-5808 | |
| (216) 292-7170 | |
| (216) 292-7182 |
| Full Name | Jay H. Berk, Ph.d., Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 23293 Commerce Park, Beachwood, Ohio |
| Authorized Official Name and Position | Jay Howard Berk (PRESIDENT) |
| Authorized Official Contact | 2162927170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jay H. Berk, Ph.d., Inc. 23293 Commerce Park Beachwood OH 44122-5808 Ph: (216) 292-7170 | Jay H. Berk, Ph.d., Inc. 23293 Commerce Park Beachwood OH 44122-5808 Ph: (216) 292-7170 |
| NPI Number | 1316261381 |
|---|---|
| Provider Enumeration Date | 03/19/2010 |
| Last Update Date | 12/04/2018 |
| Medicare PECOS PAC ID | 2961822549 |
|---|---|
| Medicare Enrollment ID | O20201020003818 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316261381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 4737 (Ohio) | Primary |
| Provider Name | Jay Howard Berk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588770622 PECOS PAC ID: 0648435081 Enrollment ID: I20120710000029 |
| Provider Name | Drena Mongo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952959397 PECOS PAC ID: 2264879956 Enrollment ID: I20240318000198 |
| Provider Name | Cory Rubeck |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1619783545 PECOS PAC ID: 4789105305 Enrollment ID: I20250311002355 |
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