| Medpsych Ohio Valley , Inc | |
|
8472 Cotter St Lewis Center OH 43035-7139 | |
| (614) 430-9697 | |
| (614) 430-9837 |
| Full Name | Medpsych Ohio Valley , Inc |
|---|---|
| Speciality | Psychologist |
| Location | 8472 Cotter St, Lewis Center, Ohio |
| Authorized Official Name and Position | Vijaykumar Balraj (OWNER) |
| Authorized Official Contact | 6144309697 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medpsych Ohio Valley , Inc 8472 Cotter St Lewis Center OH 43035-7139 Ph: (614) 430-9697 | Medpsych Ohio Valley , Inc 8472 Cotter St Lewis Center OH 43035-7139 Ph: (614) 430-9697 |
| NPI Number | 1346291085 |
|---|---|
| Provider Enumeration Date | 05/15/2006 |
| Last Update Date | 03/08/2019 |
| Medicare PECOS PAC ID | 3971514332 |
|---|---|
| Medicare Enrollment ID | O20060522000173 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346291085 | NPI | - | NPPES |
| 000000323495 | Other | OH | BCBS # |
| 2219227 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Vijaykumar B Balraj |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376592790 PECOS PAC ID: 5395787055 Enrollment ID: I20050524000490 |
| Provider Name | Jinhui Wang |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588913495 PECOS PAC ID: 0749427995 Enrollment ID: I20130508000281 |
| Provider Name | Sherry Martindell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881857613 PECOS PAC ID: 2860778255 Enrollment ID: I20170419002838 |
| Provider Name | Dru Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568971570 PECOS PAC ID: 7416207311 Enrollment ID: I20180913000689 |
| Provider Name | Patrick Henry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427608207 PECOS PAC ID: 0941640783 Enrollment ID: I20240426002955 |
| Provider Name | Kaleigh Shaye Mallek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811582976 PECOS PAC ID: 7214464080 Enrollment ID: I20241218003242 |
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