Healthcare Provider Details

I. General information

NPI: 1598468779
Provider Name (Legal Business Name): HUANZHEN PSYCHE XU PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PSYCHE XU PHD

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 W 11TH ST
CLEVELAND OH
44113-3604
US

IV. Provider business mailing address

2180 W 11TH ST
CLEVELAND OH
44113-3604
US

V. Phone/Fax

Practice location:
  • Phone: 216-800-4725
  • Fax:
Mailing address:
  • Phone: 216-800-4725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP.08448
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP.08448
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License NumberP.08448
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberP.08448
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: