Provider Demographics
NPI:1598382723
Name:OCD & ANXIETY CENTER OF CLEVELAND LLC
Entity Type:Organization
Organization Name:OCD & ANXIETY CENTER OF CLEVELAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONAH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:925-804-5532
Mailing Address - Street 1:19220 LORAIN RD STE 203
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-1976
Mailing Address - Country:US
Mailing Address - Phone:216-393-7749
Mailing Address - Fax:
Practice Address - Street 1:19220 LORAIN RD STE 203
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-1976
Practice Address - Country:US
Practice Address - Phone:216-393-7749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-04
Last Update Date:2020-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty