Healthcare Provider Details

I. General information

NPI: 1720552102
Provider Name (Legal Business Name): LAUREN NICOLE ABSHIRE PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2019
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-0517
  • Fax: 216-445-7000
Mailing address:
  • Phone: 216-445-0517
  • Fax: 216-445-7000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number08490
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: