Individual provider Active NPI

Paul G. Josell, PSYD

  • Clinical Psychologist
  • Highland Heights, OH
National Provider Identifier
1336248079
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5028 Issued in OH
Practice address
675 Alpha Dr Ste E
Highland Heights, OH 44143-2139
Phone
(440) 473-9695
NPI assigned
Sep 21, 2006
Last updated
Dec 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 5128 OH
Clinical Psychologist 103TC0700X 5028 OH Primary

Addresses

Primary practice location

675 Alpha Dr Ste E
Highland Heights, OH 44143-2139

Mailing address

5564 Wilson Mills Rd Ste 201
Highland Heights, OH 44143-3265
Phone (440) 461-1255

Other identifiers 1

IdentifierTypeStateIssuer
2987424MedicaidOH

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
I20130226000656 OH Practitioner - Clinical Psychologist 5698920528 Practice locations: Highland Heights, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

675 Alpha Dr
Suite E
Highland Heights, OH 44143-2139
Phone (440) 473-9695

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5028OHMDClinical Psychologist
5128OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
RGN Counseling LLC Single Specialty Past Accepting new patients
KLS Counseling LLC Single Specialty Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1336248079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5564 WILSON MILLS RD STE 201",
            "city": "HIGHLAND HEIGHTS",
            "state": "OH",
            "postal_code": "441433265",
            "telephone_number": "440-461-1255",
            "fax_number": "440-461-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 ALPHA DR STE E",
            "city": "HIGHLAND HEIGHTS",
            "state": "OH",
            "postal_code": "441432139",
            "telephone_number": "440-473-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSELL",
        "first_name": "PAUL",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "OH",
            "license": "5128",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2987424",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Heights, OH

Sources for this page

Verify at the official NPI Registry.