Provider Demographics
NPI:1922321033
Name:WALINSKY, JENNIFER S (PHD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:WALINSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23220 CHAGRIN BLVD
Mailing Address - Street 2:#310
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5408
Mailing Address - Country:US
Mailing Address - Phone:216-456-2402
Mailing Address - Fax:
Practice Address - Street 1:23220 CHAGRIN BLVD
Practice Address - Street 2:#310
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5408
Practice Address - Country:US
Practice Address - Phone:216-456-2402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6302103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent