Active NPI
Jessica Lebold, M.ED., ED.S.
- School Psychologist
- Mansfield, OH
National Provider Identifier
1770195182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 700 S Illinois Ave
Mansfield, OH 44907-1835 - Phone
- (419) 522-4319
- NPI assigned
- Aug 18, 2020
- 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 | Primary |
Addresses
Primary practice location
700 S Illinois Ave
Mansfield, OH 44907-1835
Mailing address
890 W 4TH St Ste 100
Mansfield, OH 44906-2561
Other practice location 1
400 Trux St
Plymouth, OH 44865-1099
Phone (419) 687-8200
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
- Credentials
- Master of Education
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597708800000",
"number": "1770195182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "890 W 4TH ST STE 100",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449062561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 S ILLINOIS AVE",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "449071835",
"telephone_number": "419-522-4319"
}
],
"practiceLocations": [
{
"address_1": "400 Trux St",
"address_purpose": "LOCATION",
"city": "Plymouth",
"state": "OH",
"postal_code": "448651099",
"country_code": "US",
"telephone_number": "419-687-8200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEBOLD",
"first_name": "JESSICA",
"credential": "M.ED., ED.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-18",
"last_updated": "2020-08-18",
"certification_date": "2020-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.