Provider Demographics
NPI:1003991274
Name:PRETZER, JAMES LEWIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEWIS
Last Name:PRETZER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24400 HIGHPOINT RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-6027
Mailing Address - Country:US
Mailing Address - Phone:216-831-2500
Mailing Address - Fax:216-831-4035
Practice Address - Street 1:24400 HIGHPOINT RD
Practice Address - Street 2:SUITE 9
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-6027
Practice Address - Country:US
Practice Address - Phone:216-831-2500
Practice Address - Fax:216-831-4035
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3258103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH34-1753069OtherTAX ID # - BEHAVIORAL HEA
OH0574623Medicaid
OH34-1753069OtherTAX ID # - BEHAVIORAL HEA
OH9265621Medicare ID - Type Unspecified