Provider Demographics
NPI:1073575106
Name:NEUROPSYCHOLOGY AND PSYCHOTHERAPY SERVICES OF CLEVELAND LLC
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGY AND PSYCHOTHERAPY SERVICES OF CLEVELAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:S
Authorized Official - Last Name:LAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:216-595-8900
Mailing Address - Street 1:23811 CHAGRIN BLVD STE 307
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5525
Mailing Address - Country:US
Mailing Address - Phone:216-595-8900
Mailing Address - Fax:216-595-0088
Practice Address - Street 1:3601 GREEN RD STE 218
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5719
Practice Address - Country:US
Practice Address - Phone:216-595-8900
Practice Address - Fax:216-595-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9326761Medicare PIN