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General NPI Number Information
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NPI Number | 1073004131
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Entity Type | Organization
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Legal Business Name | LAKEWEST DBT CENTER LLC
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Dates
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Enumeration Date | 05/24/2018
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Last Update Date | 05/24/2018
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Provider Practice Location Address
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Address Line | 15711 MADISON AVE STE 102
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City | LAKEWOOD
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State | OH
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Zip | 44107-5655
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Country | US
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Telephone | 216-787-5898
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Fax |
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Provider Business Mailing Address
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Address Line | 15711 MADISON AVE STE 102
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City | LAKEWOOD
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State | OH
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Zip | 44107-5655
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Country | US
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Telephone | 216-787-5898
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. APRIL SOBIERALSKI
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Credential | PSY.D.
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Telephone | 216-787-5898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 7261
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License Number State | OH
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