Healthcare Provider Details

I. General information

NPI: 1033024153
Provider Name (Legal Business Name): KARA GILLESPIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6579 ROYALTON RD
NORTH ROYALTON OH
44133-4925
US

IV. Provider business mailing address

6579 ROYALTON RD
NORTH ROYALTON OH
44133-4925
US

V. Phone/Fax

Practice location:
  • Phone: 440-237-8800
  • Fax:
Mailing address:
  • Phone: 440-237-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.00812
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: