Active NPI
Jacqueline Reasor, PSY.S.
- School Psychologist
- Lakewood, OH
National Provider Identifier
1700763497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- SP.00748
- Practice address
- 14900 Detroit Ave Ste 206
Lakewood, OH 44107-3922 - Phone
- (216) 200-6396
- NPI assigned
- Aug 16, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | SP.00748 | OH | Primary |
Addresses
Primary practice location
14900 Detroit Ave Ste 206
Lakewood, OH 44107-3922
Mailing address
14900 Detroit Ave Ste 206
Lakewood, OH 44107-3922
Phone (216) 200-6396
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP.00748 | OH | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755302400000",
"number": "1700763497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14900 DETROIT AVE STE 206",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441073922",
"telephone_number": "216-200-6396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14900 DETROIT AVE STE 206",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441073922",
"telephone_number": "216-200-6396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REASOR",
"first_name": "JACQUELINE",
"name_prefix": "Ms.",
"credential": "PSY.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-16",
"last_updated": "2025-08-16",
"certification_date": "2025-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "OH",
"license": "SP.00748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.