Western Reserve Psychological Assoc Inc
NPI 1063479590ActiveOrganization· Psychologist· Stow, OH
Psychologist in Stow, Ohio, registered in NPPES in April 2006. The authorized official on file is Virginia Fowkes Clark, PH D, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1063479590 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 27, 2006 |
| Last updated in NPPES | Oct 21, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (OH) |
|---|
Other Psychologist providers in Stow
- 1750548053
- 1366497083
- 1477511038
- 1790867513
- 1871550459
- 1912951708
- 1487216776
- 1952360828
- 1225095805
- 1043621386
- 1760519136
- 1225265838