Kelly Light, ED.S., NCSP

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

OH1450857 Issued in OH

Practice address

6451 Center St
Mentor, OH 44060-4109

Phone

(440) 974-5241

NPI assigned

Apr 25, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mentor Exempted Village School District

  • Local Education Agency (LEA)
  • Mentor, OH
  • NPI 1245550243
  NPD (past)

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1528488772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 CENTER ST",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 CENTER ST",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604109",
            "telephone_number": "440-974-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "ED.S., NCSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "OH1450857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evyn Lewis, LPCC-S, LICDC
• Karen Sue Lewis, N.P.
• Adina Bloom Lewkowicz, L.I.S.W.
• Michelle Ann Lieb, O.D.
• Jessica Lieberth, LPCC-S
• Sally Sederstrom Likozar, LISW
• Shawn Thomas Lillie, PT, DPT
• Toni Michelle Lima
• Dominique L. Linder
• Anthony-Jared Lino, D.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; 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.