Individual provider Active NPI

Mary Lynn Doolan, ED.S.

  • School Psychologist
  • Fairview Park, OH
National Provider Identifier
1235068651
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
LSP.00781 Issued in OH
Practice address
4507 W 213TH St
Fairview Park, OH 44126-2105
Phone
(440) 356-3500
NPI assigned
May 14, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X LSP.00781 OH Primary

Addresses

Primary practice location

4507 W 213TH St
Fairview Park, OH 44126-2105

Mailing address

4193 W 224TH St
Fairview Park, OH 44126-1849
Phone (216) 990-9213

Other names 1

  • Mary Lynn Mizenko Former name

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

State licenses

LicenseStateTypeSpecialty
LSP.00781OHMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1778716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1235068651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4193 W 224TH ST",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441261849",
            "telephone_number": "216-990-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4507 W 213TH ST",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262105",
            "telephone_number": "440-356-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOLAN",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "credential": "ED.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-14",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "LSP.00781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MIZENKO",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairview Park, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.