| Stacey B. Foerstner, Phd, Llc | |
|
4212 State Route 306 Ste 310 Willoughby OH 44094-9248 | |
| (440) 477-1007 | |
| Not Available |
| Full Name | Stacey B. Foerstner, Phd, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4212 State Route 306 Ste 310, Willoughby, Ohio |
| Authorized Official Name and Position | Stacey Brewster Foerstner (SOLE MEMBER) |
| Authorized Official Contact | 4404771007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacey B. Foerstner, Phd, Llc 4212 State Route 306 Ste 310 Willoughby OH 44094-9248 Ph: (440) 477-1007 | Stacey B. Foerstner, Phd, Llc 4212 State Route 306 Ste 310 Willoughby OH 44094-9248 Ph: (440) 477-1007 |
| NPI Number | 1487339131 |
|---|---|
| Provider Enumeration Date | 06/20/2023 |
| Last Update Date | 06/20/2023 |
| Certification Date | 06/20/2023 |
| Medicare PECOS PAC ID | 9234590670 |
|---|---|
| Medicare Enrollment ID | O20230801002211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487339131 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Stacey B Foerstner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740200245 PECOS PAC ID: 7517998883 Enrollment ID: I20111212000361 |
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