Organization Active NPI

Fairmount Professional Services, Inc

  • Psychologist
  • Cleveland Heights, OH
National Provider Identifier
1215264056
Registry record updated Nov 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
137 Issued in OH
Legal business name
FAIRMOUNT PROFESSIONAL SERVICES, INC
Practice address
2490 Lee Blvd
Suite 314
Cleveland Heights, OH 44118-1268
Phone
(216) 321-6624
NPI assigned
Nov 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2009

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

Authorized official

Name
Dr. Melvin Eugene Allerhand, PHD
Title
President
Phone
(216) 321-6624

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 137 OH Primary

Addresses

Primary practice location

2490 Lee Blvd
Suite 314
Cleveland Heights, OH 44118-1268

Mailing address

2490 Lee Blvd
Suite 314
Cleveland Heights, OH 44118-1268
Phone (216) 321-6624

Other identifiers 1

IdentifierTypeStateIssuer
400935MedicaidOH

National Provider Directory

National Provider Directory

Locations

2490 Lee Blvd
Ste 314
Cleveland Heights, OH 44118
Phone (216) 321-6624

NPI Registry JSON

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

{
    "created_epoch": "1258329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258329600000",
    "number": "1215264056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 LEE BLVD",
            "address_2": "SUITE 314",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181268",
            "telephone_number": "216-321-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 LEE BLVD",
            "address_2": "SUITE 314",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441181268",
            "telephone_number": "216-321-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMOUNT PROFESSIONAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-16",
        "last_updated": "2009-11-16",
        "status": "A",
        "authorized_official_last_name": "ALLERHAND",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-321-6624",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "OH",
            "license": "137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400935",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; 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.