Active NPI
Jorethia L Chuck, PH.D.
- Psychologist
- Cleveland, OH
National Provider Identifier
1962621177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 5755
- Practice address
- 1588 E 40TH St
Cleveland, OH 44103-2379 - Phone
- (216) 391-4970
- NPI assigned
- Apr 25, 2007
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 5755 | OH | Primary |
Addresses
Primary practice location
1588 E 40TH St
Cleveland, OH 44103-2379
Mailing address
1782 E 65TH St
Cleveland, OH 44103-3920
Phone (216) 978-0470
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2690299 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5755 | OH | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962621177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1782 E 65TH ST",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441033920",
"telephone_number": "216-978-0470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1588 E 40TH ST",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441032379",
"telephone_number": "216-391-4970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUCK",
"first_name": "JORETHIA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "5755",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2690299",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.