Individual provider Active NPI

Lori Ann Stevic-Rust

  • Health Service Psychologist
  • Willoughby, OH
National Provider Identifier
1225120975
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
4441 Issued in OH
Practice address
4132 Erie St Ste 208
Willoughby, OH 44094-7855
Phone
(440) 946-7796
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X 4441 OH Primary

Addresses

Primary practice location

4132 Erie St Ste 208
Willoughby, OH 44094-7855

Mailing address

9305 Fraser LN
Chesterland, OH 44026-3584
Phone (216) 469-2160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120208001049 OH Practitioner - Clinical Psychologist 3971760513 Practice locations: Chesterland, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Chesterland, OH 44026
Phone (216) 469-2160

9305 Fraser Lane
Chesterland, OH 44026-3584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Renee R Molzon Counseling, LLC PastSince Mar 1, 2018 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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225120975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9305 FRASER LN",
            "city": "CHESTERLAND",
            "state": "OH",
            "postal_code": "440263584",
            "telephone_number": "216-469-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4132 ERIE ST STE 208",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947855",
            "telephone_number": "440-946-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVIC-RUST",
        "first_name": "LORI",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "OH",
            "license": "4441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

Verify at the official NPI Registry.