Active NPI
Alissa Gladden
- School Psychologist
- Lewis Center, OH
National Provider Identifier
1811398241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- OH1201363
- Practice address
- 814 Shanahan Rd
Lewis Center, OH 43035-9078 - Phone
- (740) 657-5046
- NPI assigned
- Sep 4, 2014
- Sex
- Female
- Sole proprietor
- No
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 | OH1201363 | OH | Primary |
Addresses
Primary practice location
814 Shanahan Rd
Lewis Center, OH 43035-9078
Mailing address
3874 Shagbark TRL
Galena, OH 43021-8024
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 |
|---|---|---|---|
| OH1201363 | OH | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409788800000",
"number": "1811398241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3874 SHAGBARK TRL",
"city": "GALENA",
"state": "OH",
"postal_code": "430218024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 SHANAHAN RD",
"city": "LEWIS CENTER",
"state": "OH",
"postal_code": "430359078",
"telephone_number": "740-657-5046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLADDEN",
"first_name": "ALISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-04",
"last_updated": "2014-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "OH",
"license": "OH1201363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewis Center, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.