Organization Active NPI

Kortanek Psychological Services, Inc.

  • Psychologist
  • Beachwood, OH
National Provider Identifier
1053711135
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6995 Issued in OH
Legal business name
KORTANEK PSYCHOLOGICAL SERVICES, INC.
Practice address
24800 Chagrin Blvd
Suite 103
Beachwood, OH 44122-5648
Phone
(216) 245-6231
NPI assigned
Aug 26, 2014
Last updated
Sep 8, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eric Matthew Kortanek, PSY.D.
Title
President
Phone
(216) 245-6231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6995 OH Primary

Addresses

Primary practice location

24800 Chagrin Blvd
Suite 103
Beachwood, OH 44122-5648

Mailing address

24800 Chagrin Blvd
Suite 103
Beachwood, OH 44122-5648

National Provider Directory

National Provider Directory

Locations

24800 Chagrin Blvd
Ste 103
Beachwood, OH 44122
Phone (216) 245-6231

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410134400000",
    "number": "1053711135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24800 CHAGRIN BLVD",
            "address_2": "SUITE 103",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24800 CHAGRIN BLVD",
            "address_2": "SUITE 103",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225648",
            "telephone_number": "216-245-6231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KORTANEK PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-09-08",
        "status": "A",
        "authorized_official_last_name": "KORTANEK",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-245-6231",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "6995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.