North Shore Psychological Services LTD

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

NORTH SHORE PSYCHOLOGICAL SERVICES LTD

Practice address

355 W Prospect Rd
Suite 124
Ashtabula, OH 44004-5830

Phone

(440) 992-1144

Fax

(440) 998-1996

NPI assigned

Nov 18, 2005

Last updated

Aug 21, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David L Hausman

Title

Treasurer

Phone

(440) 992-1144

Specialties & licenses 6

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bonnie L Eidens, MSSA, LISW, CEAP

  • Social Worker
  • Geneva, OH
  • NPI 1457331563
  NPD (past)
• Ellen H Jacobs, MSW, LISW, DCSW

  • Social Worker
  • Ashtabula, OH
  • NPI 1033199419
  NPD (past)
• Michael J Primc, MD

  • Psychiatry Physician
  • Mentor, OH
  • NPI 1992838908
  NPD (past)
• Patricia A Gillette, PHD

  • Cognitive & Behavioral Psychologist
  • Tucson, AZ
  • NPI 1730161225

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1487636965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 W PROSPECT RD STE 124",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440045830",
            "telephone_number": "440-992-1144",
            "fax_number": "440-998-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W PROSPECT RD",
            "address_2": "SUITE 124",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440045830",
            "telephone_number": "440-992-1144",
            "fax_number": "440-998-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE PSYCHOLOGICAL SERVICES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "HAUSMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "440-992-1144",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damon Jerrod Norman
• Jennifer Norman, REGISTERED NURSE
• Kara Norman
• Leona Rae Norman
• Jacqueline G Norris, SLP
• Nicole Marie Noscal, LISW
• David J. Novak, M.D.
• Andrea Nunley
• Nawjia Nuzum
• Valerie Nye

• Psychologist in Ashtabula, OH
• Providers in Ashtabula, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.