Lucy Idol Center, Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

0077 Issued in OH

Legal business name

LUCY IDOL CENTER, INC

Practice address

435 Nicholson Rd
Vermilion, OH 44089-2536

Phone

(440) 967-6724

Fax

(440) 967-4495

NPI assigned

Feb 22, 2006

Organization subpart

No

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

Authorized official

Name

John Tad Peck

Title

Executive Director

Phone

(440) 967-6724

Specialties & licenses 10

Addresses

Locations

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1962477901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 162",
            "address_2": "435 NICHOLSON AVE",
            "city": "VERMILION",
            "state": "OH",
            "postal_code": "440890162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 NICHOLSON RD",
            "city": "VERMILION",
            "state": "OH",
            "postal_code": "440892536",
            "telephone_number": "440-967-6724",
            "fax_number": "440-967-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCY IDOL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "TAD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "440-967-6724"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Interpreter",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "OH",
            "license": "0077",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole E Leach, CNP
• Marcie Marie Lewis, LPN
• Carol S Limbert Lerch, SPEECH THERAPIST
• Laura L Lloyd, MS CCC SLP
• Valerie Lorson, PT, DPT
• Ashley Lugo
• Zachary A Malin, MAT, ATC
• Laura Mangus
• Meagan Markovich, PHARM D
• Kendra Martin

• Mental Health Clinic/Center (Including Community Mental Health Center) in Vermilion, OH
• Providers in Vermilion, OH by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.