Healthcare Provider Details

I. General information

NPI: 1225044175
Provider Name (Legal Business Name): ROBERT GARY KAPLAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 05/27/2020
Certification Date: 05/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3690 ORANGE PL STE 170
BEACHWOOD OH
44122-4465
US

IV. Provider business mailing address

3690 ORANGE PL STE 170
BEACHWOOD OH
44122-4465
US

V. Phone/Fax

Practice location:
  • Phone: 216-642-8283
  • Fax: 216-937-0187
Mailing address:
  • Phone: 216-642-8283
  • Fax: 216-937-0187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3518
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number3518
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: