NPIMap

Organization Active NPI

Landings Family & Psychological Center, Inc.

  • Clinical Psychologist
  • Avon Lake, OH
National Provider Identifier
1790952000
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1813 Issued in OH
Legal business name
LANDINGS FAMILY & PSYCHOLOGICAL CENTER, INC.
Practice address
32730 Walker Rd
Suite I-5
Avon Lake, OH 44012-4100
Phone
(440) 933-8770
Fax
(440) 933-8991
NPI assigned
May 15, 2008
Last updated
Oct 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Authorized official

Name
Dr. Ronald J Mistur, PH.D.NPI 1558335075
Title
Licensed Psychologist
Phone
(440) 933-8770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1813 OH Primary
Clinical Social Worker 1041C0700X I1717 OH
Clinical Social Worker 1041C0700X I1878 OH
Clinical Social Worker 1041C0700X I2914 OH

Addresses

Primary practice location

32730 Walker Rd
Suite I-5
Avon Lake, OH 44012-4100

Mailing address

32730 Walker Rd
Suite I-5
Avon Lake, OH 44012-4100
Phone (440) 933-8770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100329001064 OH Part B Supplier - Clinic/Group Practice 1052447034 Receives reassigned benefits from 2 practitioners
Practice locations: Bay Village, OH

National Provider Directory

National Provider Directory

Locations

32730 Walker Rd
Ste I5
Avon Lake, OH 44012
Phone (440) 787-6311

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1790952000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32730 WALKER RD",
            "address_2": "SUITE I-5",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440124100",
            "telephone_number": "440-933-8770",
            "fax_number": "440-933-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32730 WALKER RD",
            "address_2": "SUITE I-5",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440124100",
            "telephone_number": "440-933-8770",
            "fax_number": "440-933-8991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDINGS FAMILY & PSYCHOLOGICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "MISTUR",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "440-933-8770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "1813",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1717",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1878",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I2914",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon Lake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.