Healthcare Provider Details

I. General information

NPI: 1558205054
Provider Name (Legal Business Name): FOUNDATION ASSESSMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2963 BLUE JACKET CT
LIMA OH
45806-1464
US

IV. Provider business mailing address

2963 BLUE JACKET CT
LIMA OH
45806-1464
US

V. Phone/Fax

Practice location:
  • Phone: 419-405-3383
  • Fax:
Mailing address:
  • Phone:
  • Fax: 419-405-3383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHANA STOBER
Title or Position: BUSINESS OWNER, SCHOOL PSYCHOLOGIST
Credential: ED.D, NCSP, ILSP
Phone: 419-303-3344