| Western Reserve Psychological Assoc Inc | |
|
4833 Darrow Road Suite 101 Stow OH 44224-1411 | |
| (330) 650-5338 | |
| (330) 342-3837 |
| Full Name | Western Reserve Psychological Assoc Inc |
|---|---|
| Speciality | Psychologist |
| Location | 4833 Darrow Road, Stow, Ohio |
| Authorized Official Name and Position | Virginia Fowkes Clark (PRESIDENT) |
| Authorized Official Contact | 3306506338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Reserve Psychological Assoc Inc 4833 Darrow Road Suite 101 Stow OH 44224-1411 Ph: (330) 650-5338 | Western Reserve Psychological Assoc Inc 4833 Darrow Road Suite 101 Stow OH 44224-1411 Ph: (330) 650-5338 |
| NPI Number | 1063479590 |
|---|---|
| Provider Enumeration Date | 04/27/2006 |
| Last Update Date | 10/21/2015 |
| Medicare PECOS PAC ID | 4587644489 |
|---|---|
| Medicare Enrollment ID | O20040721001612 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063479590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Tracy M Dawyduk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790867513 PECOS PAC ID: 3870583966 Enrollment ID: I20040512000885 |
| Provider Name | John S Schell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518927748 PECOS PAC ID: 5890790729 Enrollment ID: I20060927000016 |
| Provider Name | Virginia Fowkes Clark |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477511038 PECOS PAC ID: 8527167923 Enrollment ID: I20070626000626 |
| Provider Name | Joyce L Giovannelli |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831364421 PECOS PAC ID: 5698844801 Enrollment ID: I20080514000318 |
| Provider Name | Eve Whitmore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922065697 PECOS PAC ID: 1759569445 Enrollment ID: I20110628000671 |
| Provider Name | Jay Levine |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225265838 PECOS PAC ID: 5294901815 Enrollment ID: I20120104000075 |
| Provider Name | Mary Elizabeth Hickcox |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043621386 PECOS PAC ID: 1456577121 Enrollment ID: I20140801001677 |
| Provider Name | Nathan Aaron Lamkin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871971309 PECOS PAC ID: 5092028803 Enrollment ID: I20150723007173 |
| Provider Name | Donna Lucille Mcdonald |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346020096 PECOS PAC ID: 2668828484 Enrollment ID: I20231030002627 |
| Provider Name | Tanisha L Knighton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912149717 PECOS PAC ID: 3173069762 Enrollment ID: I20240718004022 |
| Provider Name | Ross Patrick Robertson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457978892 PECOS PAC ID: 8628519105 Enrollment ID: I20240924003487 |
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