Individual provider Active NPI

Richard J Shurell, PHD

  • Psychologist
  • Stow, OH
National Provider Identifier
1114979341
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3027 Issued in OH
Practice address
4833 Darrow Road Suite 101
Western Reserve Psychological Associates Inc
Stow, OH 44224-1411
Phone
(330) 650-5338
Fax
(330) 342-3837
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3027 OH Primary
Cognitive & Behavioral Psychologist 103TB0200X 3027 OH
Clinical Psychologist 103TC0700X 3027 OH
Exercise & Sports Psychologist 103TE1100X 3027 OH
Forensic Psychologist 103TF0200X 3027 OH

Addresses

Primary practice location

4833 Darrow Road Suite 101
Western Reserve Psychological Associates Inc
Stow, OH 44224-1411

Mailing address

4833 Darrow Road Suite 101
Western Reserve Psychological Associates Inc
Stow, OH 44224-1411
Phone (330) 650-5338

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Western Reserve Psychological Assoc Inc Psychologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292284800000",
    "number": "1114979341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4833 DARROW ROAD SUITE 101",
            "address_2": "WESTERN RESERVE PSYCHOLOGICAL ASSOCIATES INC",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442241411",
            "telephone_number": "330-650-5338",
            "fax_number": "330-342-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4833 DARROW ROAD SUITE 101",
            "address_2": "WESTERN RESERVE PSYCHOLOGICAL ASSOCIATES INC",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442241411",
            "telephone_number": "330-650-5338",
            "fax_number": "330-342-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHURELL",
        "first_name": "RICHARD",
        "middle_name": "J",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2010-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "3027",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "OH",
            "license": "3027",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3027",
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "OH",
            "license": "3027",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "OH",
            "license": "3027",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stow, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.