Provider Demographics
NPI:1346298734
Name:SPECTRUM PSYCHOLOGICAL ASSOCIATES, INC
Entity Type:Organization
Organization Name:SPECTRUM PSYCHOLOGICAL ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSSMAN-MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:216-702-1913
Mailing Address - Street 1:6151 WILSON MILLS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2128
Mailing Address - Country:US
Mailing Address - Phone:162-702-1913
Mailing Address - Fax:877-689-9547
Practice Address - Street 1:6151 WILSON MILLS RD STE 200
Practice Address - Street 2:
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2128
Practice Address - Country:US
Practice Address - Phone:216-702-1913
Practice Address - Fax:877-689-9547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSP9341561Medicare ID - Type Unspecified