Healthcare Provider Details

I. General information

NPI: 1952649626
Provider Name (Legal Business Name): COLLEEN LORBER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2013
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1956 W 25TH ST STE 200
CLEVELAND OH
44113-3450
US

IV. Provider business mailing address

1956 W 25TH ST STE 200
CLEVELAND OH
44113-3450
US

V. Phone/Fax

Practice location:
  • Phone: 216-606-9328
  • Fax:
Mailing address:
  • Phone: 216-606-9328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6541
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: