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General NPI Number Information
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NPI Number | 1205771508
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Entity Type | Individual
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Provider Name | MARY ELLEN KAUCHECK PSY.S.
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Gender | Female
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 528 GARFORD AVE
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City | ELYRIA
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State | OH
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Zip | 44035-6410
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Country | US
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Telephone | 440-284-8011
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Fax |
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Provider Business Mailing Address
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Address Line | 27652 REMINGTON DR
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City | WESTLAKE
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State | OH
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Zip | 44145-2164
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Country | US
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Telephone | 440-284-8071
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | LSP.00680
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License Number State | OH
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