Elizabeth B Wyatt PHD Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4508 Issued in OH

Legal business name

ELIZABETH B WYATT PHD INC

Practice address

8039 Broadmoor Rd
Suite 15
Mentor, OH 44060-7577

Phone

(440) 269-1500

Fax

(440) 269-8545

NPI assigned

Jun 10, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Elizabeth Blair Wyatt, PH.D.

Title

President

Phone

(440) 269-1500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276128000000",
    "number": "1407176605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8039 BROADMOOR RD",
            "address_2": "SUITE 15",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607577",
            "telephone_number": "440-269-1500",
            "fax_number": "440-269-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8039 BROADMOOR RD",
            "address_2": "SUITE 15",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607577",
            "telephone_number": "440-269-1500",
            "fax_number": "440-269-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH B WYATT PHD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-10",
        "last_updated": "2010-06-10",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "BLAIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-269-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "4508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Eippert, RPH
• Danielle Eisenberg, LISW
• Paul H Eisenberg, DPM
• Ashley Marie El-Khoury, LPCC
• Kari L Elam
• Ellen L. Ellsworth, OD Inc
• Clay Ellenwood, PA-C
• Kristi Ann Ellis, PHARMD
• Jeanine Ellison
• Ellen Lille Ellsworth, O.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; 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.