Provider Demographics
NPI:1518952191
Name:LANCASTER, JODI L (MA CCCA)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:L
Last Name:LANCASTER
Suffix:
Gender:F
Credentials:MA CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 W CEDAR ST
Mailing Address - Street 2:STE 106
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-2551
Mailing Address - Country:US
Mailing Address - Phone:330-376-1221
Mailing Address - Fax:330-376-3953
Practice Address - Street 1:157 W CEDAR ST
Practice Address - Street 2:STE 106
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307-2564
Practice Address - Country:US
Practice Address - Phone:330-376-1221
Practice Address - Fax:330-376-3953
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00759231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH45-00027OtherUNITED HEALTHCARE
OH341713667027OtherCARESOURCE
OH61248OtherQUALCHOICE
OH0883441Medicaid
OH000000137222OtherANTHEM
OH61248OtherQUALCHOICE