Provider Demographics
NPI:1205803517
Name:LECHOWICK, THOMAS PATRICK (MA)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:PATRICK
Last Name:LECHOWICK
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W MAIN ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:GENEVA
Mailing Address - State:OH
Mailing Address - Zip Code:44041-1206
Mailing Address - Country:US
Mailing Address - Phone:440-466-7775
Mailing Address - Fax:440-466-7775
Practice Address - Street 1:203 W MAIN ST
Practice Address - Street 2:SUITE 107
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-1206
Practice Address - Country:US
Practice Address - Phone:440-466-7775
Practice Address - Fax:440-466-7775
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-06
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2589103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341630273OtherCLINICAL PSYCHOLOGIST
OH0356458Medicaid
OHLE0551821Medicare ID - Type Unspecified