Individual provider Active NPI

Jonah Lakin, PSYD

  • Cognitive & Behavioral Psychologist
  • Fairview Park, OH
National Provider Identifier
1750706677
Registry record updated Jul 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
P.07764 Issued in OH
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

Updated by the provider on Jul 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
P.07764OHMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ocd & Anxiety Center of Cleveland LLC Clinical CurrentSince Jul 12, 2020 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.

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.

Verify at the official NPI Registry.