Active NPI
Jonah Lakin, PSYD
- Cognitive & Behavioral Psychologist
- Fairview Park, OH
National Provider Identifier
1750706677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- P.07764
- Practice address
- 19220 Lorain Rd Ste 203
Fairview Park, OH 44126-1976 - Phone
- (216) 393-7749
- NPI assigned
- Feb 28, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 26269 | CA | |
| Cognitive & Behavioral Psychologist | 103TB0200X | P.07764 | OH | Primary |
Addresses
Primary practice location
19220 Lorain Rd Ste 203
Fairview Park, OH 44126-1976
Mailing address
19220 Lorain Rd Ste 203
Fairview Park, OH 44126-1976
Phone (216) 393-7749
Other practice location 1
2363 Boulevard Cir
Suite 12A
Walnut Creek, CA 94595-1177
Phone (650) 532-3666
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 |
|---|---|---|---|
| P.07764 | OH | MD | Cognitive & Behavioral Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ocd & Anxiety Center of Cleveland LLC | Clinical | Current | Accepting new patients |
Locations
19220 Lorain Rd
Ste 203
Fairview Park, OH 44126
Phone (216) 393-7749
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.
-
- Clinical Psychologist
- Fairview Park, OH
- NPI 1598382723
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593820800000",
"number": "1750706677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19220 LORAIN RD STE 203",
"city": "FAIRVIEW PARK",
"state": "OH",
"postal_code": "441261976",
"telephone_number": "216-393-7749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19220 LORAIN RD STE 203",
"city": "FAIRVIEW PARK",
"state": "OH",
"postal_code": "441261976",
"telephone_number": "216-393-7749"
}
],
"practiceLocations": [
{
"address_1": "2363 Boulevard Cir",
"address_2": "Suite 12A",
"address_purpose": "LOCATION",
"city": "Walnut Creek",
"state": "CA",
"postal_code": "945951177",
"country_code": "US",
"telephone_number": "650-532-3666",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAKIN",
"first_name": "JONAH",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-28",
"last_updated": "2020-07-04",
"certification_date": "2020-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "26269",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "OH",
"license": "P.07764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairview Park, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.