Lajean'S Mental Health Boutique, LLC

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

Legal business name

LAJEAN'S MENTAL HEALTH BOUTIQUE, LLC

Doing business as

Lajeans Mental Health Rehab
Lajeans Mental Health Rehab Boutique LLC.
LajeansMHB LLC

Practice address

10 Columbus St
Bedford, OH 44146-2819

Phone

(330) 595-9929

Fax

(845) 859-8649

NPI assigned

Dec 14, 2020

Organization subpart

Yes

Parent organization

LAJEANS MENTAL HEALTH BOUTIQUE LLCAs reported in NPPES

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

Authorized official

Name

Ms. Dewan Smith-Williams, PHMAPRN-CNP-BC

Title

Ceo

Phone

(330) 907-1556

Specialties & licenses 1

Addresses

Other names 3

• Lajeans Mental Health Rehab Doing business as
• Lajeans Mental Health Rehab Boutique LLC. Doing business as
• LajeansMHB LLC Doing business as

Part of

Lajeans Mentall Health Bout

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Harris

  • Nurse Practitioner
  • Cleveland, OH
  • NPI 1518416304
  NPD (past)

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640476800000",
    "number": "1205422342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 WOODVIEW DR",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443191343",
            "telephone_number": "330-907-1556",
            "fax_number": "213-203-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 COLUMBUS ST",
            "city": "BEDFORD",
            "state": "OH",
            "postal_code": "441462819",
            "telephone_number": "330-595-9929",
            "fax_number": "845-859-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAJEAN'S MENTAL HEALTH BOUTIQUE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAJEANS MENTAL HEALTH BOUTIQUE LLC",
        "enumeration_date": "2020-12-14",
        "last_updated": "2021-12-26",
        "certification_date": "2021-12-26",
        "status": "A",
        "authorized_official_last_name": "SMITH-WILLIAMS",
        "authorized_official_first_name": "DEWAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-907-1556",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHMAPRN-CNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lajeans Mental Health Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lajeans Mental Health Rehab Boutique LLC.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LajeansMHB LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ildiko T Kondray, MD
• Natalya Kornyushenko
• Jill Renee Kramer, AU.D.
• Clayteya Kyle
• Kymco Reliable Home Care
• Lajean'S Mental Health Boutique, LLC
• Trina Larkin
• Roxanne Lauderdale
• Syauna Jorie Lauderdale
• Samantha Law

• Addiction Psychiatry Physician in Bedford, OH
• Providers in Bedford, OH by specialty
• Addiction Psychiatry Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2021; 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.