Samina Ahmed Jauregui, PSYD

Individual provider Active NPI Clinical Psychologist · Cleveland, OH

NPI 1104256916 · NPPES record last updated Dec 31, 2020

Key facts

NPI
1104256916
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
P.07819 (OH)
Practice address
11100 Euclid Ave
Cleveland, OH 44106-1716
Phone
(216) 286-7150
NPI assigned
Nov 14, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P.07819 OH Yes

Addresses

Primary practice location

11100 Euclid Ave
Cleveland, OH 44106-1716

Mailing address

11100 Euclid Ave FL Bolwell6
Cleveland, OH 44106-1716
Phone (216) 286-7150

Other practice location 1

3375 N Arlington Heights Rd
Suite J
Arlington Heights, IL 60004-7701
Phone (847) 394-4174 ext. 130

Other identifiers

IdentifierTypeStateIssuer
178.008576OtherILILLINOIS STATE LICENSE

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address saminaahmed@uhps.allscriptsdirect.net

Other providers in Cleveland, OH

All providers in Cleveland, OH · Clinical Psychologist in Ohio

Sources for this page

Verify at the official NPI Registry.