Active NPI
Raymond D Richetta, PH.D.
- Psychologist
- Beachwood, OH
National Provider Identifier
1265486922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3981
- Practice address
- 24100 Chagrin Blvd
Suite 400
Beachwood, OH 44122-5535 - Phone
- (216) 831-1040
- Fax
- (216) 831-2667
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3981 | OH | Primary |
Addresses
Primary practice location
24100 Chagrin Blvd
Suite 400
Beachwood, OH 44122-5535
Mailing address
25700 Science Park Drive.
Landmark Centre Suite 200
Beachwood, OH 44122
Phone (216) 831-1040
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| O700281 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3981 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478649600000",
"number": "1265486922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25700 SCIENCE PARK DRIVE.",
"address_2": "LANDMARK CENTRE SUITE 200",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "44122",
"telephone_number": "216-831-1040",
"fax_number": "216-831-2667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24100 CHAGRIN BLVD",
"address_2": "SUITE 400",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441225535",
"telephone_number": "216-831-1040",
"fax_number": "216-831-2667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHETTA",
"first_name": "RAYMOND",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2016-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "3981",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "O700281",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.