Active NPI
Lisa Maletich
- School Psychologist
- Port Clinton, OH
National Provider Identifier
1962820423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- OH1031089
- Practice address
- 821 Jefferson St
Port Clinton, OH 43452-2415 - Phone
- (419) 734-2147
- Fax
- (419) 732-0892
- NPI assigned
- Apr 2, 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 | OH1031089 | OH | Primary |
Addresses
Primary practice location
821 Jefferson St
Port Clinton, OH 43452-2415
Mailing address
821 Jefferson St
Port Clinton, OH 43452-2415
Phone (419) 734-2147
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 |
|---|---|---|---|
| OH1031089 | OH | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Port Clinton City Schools | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Local Education Agency (LEA)
- Port Clinton, OH
- NPI 1174725113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396396800000",
"number": "1962820423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "821 JEFFERSON ST",
"city": "PORT CLINTON",
"state": "OH",
"postal_code": "434522415",
"telephone_number": "419-734-2147",
"fax_number": "419-732-0892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "821 JEFFERSON ST",
"city": "PORT CLINTON",
"state": "OH",
"postal_code": "434522415",
"telephone_number": "419-734-2147",
"fax_number": "419-732-0892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALETICH",
"first_name": "LISA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-02",
"last_updated": "2014-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "OH",
"license": "OH1031089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Clinton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.