Individual provider Active NPI

Suzanne Lesure, PH.D

  • Clinical Psychologist
  • Fairview Park, OH
National Provider Identifier
1689631277
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3456 Issued in OH
Practice address
4475 Valley Forge Dr
Fairview Park, OH 44126-2826
Phone
(330) 418-7887
Fax
(330) 776-5557
NPI assigned
Apr 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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 3456 OH Primary

Addresses

Primary practice location

4475 Valley Forge Dr
Fairview Park, OH 44126-2826

Mailing address

4475 Valley Forge Dr
Fairview Park, OH 44126-2826
Phone (330) 418-7887

Other identifiers 1

IdentifierTypeStateIssuer
0607329MedicaidOH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150603002695 OH Practitioner - Clinical Psychologist 1254351026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Fairview Park, OH 44126
Phone (330) 418-7887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3456OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lesure and Associates CurrentSince Nov 11, 2005 Accepting new patients

Locations

221 W Liberty St
Medina, OH 44256
Phone (330) 410-8444

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1689631277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4475 VALLEY FORGE DR",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262826",
            "telephone_number": "330-418-7887",
            "fax_number": "330-776-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 VALLEY FORGE DR",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262826",
            "telephone_number": "330-418-7887",
            "fax_number": "330-776-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESURE",
        "first_name": "SUZANNE",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0607329",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Park, OH

Sources for this page

Verify at the official NPI Registry.