Individual provider Active NPI

Anita Forsberg Culbertson, PSYD

  • Clinical Psychologist
  • Lyndhurst, OH
National Provider Identifier
1497861199
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6125 Issued in OH
Practice address
5001 Mayfield Rd
200
Lyndhurst, OH 44124-2602
Phone
(216) 291-4000
Fax
(216) 291-4111
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6125 OH Primary

Addresses

Primary practice location

5001 Mayfield Rd
200
Lyndhurst, OH 44124-2602

Mailing address

5001 Mayfield Rd
200
Lyndhurst, OH 44124-2602
Phone (216) 291-4000

Other identifiers 3

IdentifierTypeStateIssuer
P00272062OtherOHRAILROAD MEDICARE
000000370900OtherOHANTHEM
2570589MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6125OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Transitions, Inc Clinical PastSince Apr 1, 1995 Accepting new patients

Organizations & group practices 1

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497861199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 MAYFIELD RD",
            "address_2": "200",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242602",
            "telephone_number": "216-291-4000",
            "fax_number": "216-291-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 MAYFIELD RD",
            "address_2": "200",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242602",
            "telephone_number": "216-291-4000",
            "fax_number": "216-291-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULBERTSON",
        "first_name": "ANITA",
        "middle_name": "FORSBERG",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00272062",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000370900",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2570589",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndhurst, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.