NPIMap

Organization Active NPI

Medpsych Ohio Valley , Inc

Doing business as Psychological Health Services

  • Psychologist
  • Lewis Center, OH
National Provider Identifier
1346291085
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MEDPSYCH OHIO VALLEY , INC
Doing business as
Psychological Health Services
Practice address
8472 Cotter St
Lewis Center, OH 43035-7139
Phone
(614) 430-9697
Fax
(614) 430-9837
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Authorized official

Name
Dr. Vijaykumar Balraj, PHDNPI 1376592790
Title
Owner
Phone
(614) 430-9697

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

8472 Cotter St
Lewis Center, OH 43035-7139

Mailing address

8472 Cotter St
Lewis Center, OH 43035-7139
Phone (614) 430-9697

Other identifiers 2

IdentifierTypeStateIssuer
000000323495OtherOHBCBS #
2219227MedicaidOH

Other names 1

  • PSYCHOLOGICAL HEALTH SERVICES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060522000173 OH Part B Supplier - Clinic/Group Practice 3971514332 Receives reassigned benefits from 6 practitioners
Practice locations: Lewis Center, OH

National Provider Directory

National Provider Directory

Locations

2000 Polaris Pkwy
Ste 100
Columbus, OH 43240
Phone (614) 330-1876

1010 Woodman Dr
Dayton, OH 45432
Phone (937) 252-5500

8472 Cotter St
Lewis Center, OH 43035

7100 Graphics Way
Ste 3300
Lewis Center, OH 43035
Phone (224) 217-2562

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552003200000",
    "number": "1346291085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8472 COTTER ST",
            "city": "LEWIS CENTER",
            "state": "OH",
            "postal_code": "430357139",
            "telephone_number": "614-430-9697",
            "fax_number": "614-430-9837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8472 COTTER ST",
            "city": "LEWIS CENTER",
            "state": "OH",
            "postal_code": "430357139",
            "telephone_number": "614-430-9697",
            "fax_number": "614-430-9837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDPSYCH OHIO VALLEY , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2019-03-08",
        "status": "A",
        "authorized_official_last_name": "BALRAJ",
        "authorized_official_first_name": "VIJAYKUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-430-9697",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS #",
            "identifier": "000000323495",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2219227",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PSYCHOLOGICAL HEALTH SERVICES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PSYCHOLOGICAL HEALTH SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewis Center, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.