NPIMap

Organization Active NPI

Patricia J Masterson PHD LLC

  • Psychologist
  • Woodmere, OH
National Provider Identifier
1306160775
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3080 Issued in OH
Legal business name
PATRICIA J MASTERSON PHD LLC
Practice address
28001 Chagrin Blvd
212
Woodmere, OH 44122-4559
Phone
(216) 292-7170
Fax
(216) 292-7182
NPI assigned
Mar 15, 2010
Last updated
Aug 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Authorized official

Name
Patricia J Masterson, PH.D.NPI 1154305092
Title
Counseling Psychologist
Phone
(216) 292-7170

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 3080 OH Primary

Addresses

Primary practice location

28001 Chagrin Blvd
212
Woodmere, OH 44122-4559

Mailing address

23360 Chagrin Blvd.
Ste. 110
Beachwood, OH 44122
Phone (216) 595-3175

Other identifiers 1

IdentifierTypeStateIssuer
3037118MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312329600000",
    "number": "1306160775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23360 CHAGRIN BLVD.",
            "address_2": "STE. 110",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-595-3175",
            "fax_number": "216-595-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28001 CHAGRIN BLVD",
            "address_2": "212",
            "city": "WOODMERE",
            "state": "OH",
            "postal_code": "441224559",
            "telephone_number": "216-292-7170",
            "fax_number": "216-292-7182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA J MASTERSON PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2011-08-03",
        "status": "A",
        "authorized_official_last_name": "MASTERSON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COUNSELING PSYCHOLOGIST",
        "authorized_official_telephone_number": "216-292-7170",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "OH",
            "license": "3080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3037118",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodmere, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.