Jack J. Lesyk, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1050 Issued in OH

Practice address

21625 Chagrin Blvd
Suite 200
Beachwood, OH 44122-5363

Phone

(216) 575-6175

Fax

(216) 491-0155

NPI assigned

Aug 24, 2005

Last updated

Apr 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jack J. Lesyk, PH.D., Inc.

  • Clinical Psychologist
  • Beachwood, OH
  • NPI 1649263765
  Authorized official Same address or phone

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1326031444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21625 CHAGRIN BLVD",
            "address_2": "SUITE 200",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225363",
            "telephone_number": "216-575-6175",
            "fax_number": "216-491-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21625 CHAGRIN BLVD",
            "address_2": "SUITE 200",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225363",
            "telephone_number": "216-575-6175",
            "fax_number": "216-491-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESYK",
        "first_name": "JACK",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "1050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.