Tania Lodge, PHD, PCC-S

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P.08616 Issued in OH

Practice address

3618 W Market St Ste 15
Fairlawn, OH 44333-2425

Phone

(234) 466-0445

Fax

(234) 466-0359

NPI assigned

Jul 29, 2008

Last updated

Apr 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tanialodge@tdh.allscriptsdirect.net

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.

• Kindred Spirit Behavioral Health

  • Community/Behavioral Health Agency
  • Fairlawn, OH
  • NPI 1093475899
  Medicare reassignment NPD Authorized official
• Kindred Spirit Behavioral Health

  • Community/Behavioral Health Agency
  • Fairlawn, OH
  • NPI 1396493185
  NPD (past) Authorized official
• Kindred Spirit Behavioral Health

  • Community/Behavioral Health Agency
  • Fairlawn, OH
  • NPI 1871458000
  NPD (past) Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD
• Pathway Caring for Childen

  • Case Management Agency
  • North Canton, OH
  • NPI 1285734277
  NPD (past)
• Pathway Caring for Children

  • Community/Behavioral Health Agency
  • North Canton, OH
  • NPI 1912161720
  NPD (past)

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1437315520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3618 W MARKET ST STE 16",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443332425",
            "telephone_number": "234-466-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3618 W MARKET ST STE 15",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443332425",
            "telephone_number": "234-466-0445",
            "fax_number": "234-466-0359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6370 Wise Ave NW",
            "address_purpose": "LOCATION",
            "city": "North Canton",
            "state": "OH",
            "postal_code": "447207350",
            "country_code": "US",
            "telephone_number": "330-493-0083 x3664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LODGE",
        "first_name": "TANIA",
        "name_prefix": "Dr.",
        "credential": "PHD, PCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0500437",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "P.08616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0214582",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drtanialodge@Kno2.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3618 W Market St Ste 15",
            "city": "Fairlawn",
            "state": "OH",
            "country_code": "US",
            "postal_code": "443332425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Onyema Lindsey
• Rose Lintelman, OTR
• Michael H Linz, MD
• Alyssa Hulthen Lobban
• Diane Marie Locigno, SWT BA
• Elyssa Loede
• Jordan Logozny, DC
• Jessica Long, QMHS-BA
• Linda Long, BCBA
• Jennifer Leigh Longacre

• Clinical Psychologist in Fairlawn, OH
• Providers in Fairlawn, 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 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.