LAKEWEST DBT CENTER LLC (NPI# 1073004131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073004131 |
| Entity Type | Organization |
| Organization Name | LAKEWEST DBT CENTER LLC |
| Other Organization Name | TABONO CENTER FOR WELLBEING |
| Practice Address |
15711 Madison Ave Ste 102 Lakewood OH 44107-5655 |
| Practice Telephone | 2167875898 |
| Mailing Telephone | 2167875898 |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |
| Authorized Official Name | DR. APRIL SOBIERALSKI (CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 2167875898 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | TABONO CENTER FOR WELLBEING |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
7261 | OH | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 1073866158 | 05 |
| Other Name | Type Code |
|---|---|
| Tabono Center for Wellbeing | Doing Business As Name - Organization |
| Street Address |
15711 MADISON AVE STE 102 |
| City | LAKEWOOD |
| State | OH |
| Zip Code | 44107-5655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326522210 | Lawrence M Roth | Social Worker | 14701 Detroit Ave Ste 363, Lakewood, OH 44107 | 2018-09-18 |
| 1376065730 | Fareeha Khan | Internal Medicine | 12540 Edgewater Drive, Apt 411, Lakewood, OH 44107 | 2017-07-07 |
| 1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
| 1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
| 1255882551 | Kristen Murray | Dietitian, Registered | 14900 Detroit Ave Ste 207, Lakewood, OH 44107 | 2016-10-21 |
| 1265828131 | David Thomas Jonke | Dentist | 15640 Madison Ave., Lakewood, OH 44107 | 2015-04-08 |
| 1760885941 | Debra Watkins | Home Health Aide | 1510 Newman Ave Apt 406, Lakewood, OH 44107 | 2014-10-02 |
| 1396155198 | Monica M Owen | Occupational Therapist | 9200 Biddulph Rd., Brooklyn, OH 44107 | 2014-05-01 |
| 1730512229 | Marsha Elaine Favors | Licensed Practical Nurse | 1448 Lakeland Ave, Lakewood, OH 44107 | 2013-08-20 |
| 1508130006 | Ruth Rachel Raciniewski | Counselor | 15200 Madison Avenue, Lakewood, OH 44107 | 2012-03-01 |
| Find all providers in zip 44107 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1295237212 | Preferred Behavioral Health of New Jersey, Inc | Clinic/Center | 1200 River Ave Ste 9d, Lakewood, NJ 08701-5657 | 2018-03-06 |
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| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.