MEDICARE: CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	213E00000X	Podiatrist
2	363L00000X	Nurse Practitioner
3	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1689489718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING

Provider Business Mailing Address
First Line	:	5535 PEACH ST
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16509-2603
Country	:	US
Telephone Number	:	814-844-2858
Fax Number	:

Provider Business Practice Location Address
First Line	:	16954 CONNEAUT LAKE RD
Second Line	:
City	:	MEADVILLE
State	:	PA
Zip	:	16335-3738
Country	:	US
Telephone Number	:	814-844-2858
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES LIN
Credential	:
Telephone Number	:	814-602-7783

Provider Enumeration Date	:	02/07/2025
Last Update Date	:	10/13/2025

Similar Medicare Providers

1437152006 — MS. JULIE S. KNAPKA CRNP
Practice Location Address:

16954 CONNEAUT LAKE RD
MEADVILLE, PA
16335-3738

Practice Phone: 814-200-9904
Practice Fax: 814-540-4026

1164499570 — DR. GREGORY R MURRAY DO
Practice Location Address:

16954 CONNEAUT LAKE RD
MEADVILLE, PA
16335-3738

Practice Phone: 866-962-3210
Practice Fax: 814-336-4255

1447072731 — CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING
Practice Location Address:

16954 CONNEAUT LAKE RD
MEADVILLE, PA
16335-3738

Practice Phone: 814-868-2200
Practice Fax:

1093798837 — CYNTHIA D NOVOTNY PA-C
Practice Location Address:

17128 MULLEN RD
MEADVILLE, PA
16335-6318

Practice Phone: 814-724-7429
Practice Fax:

1942276423 — MEADVILLE MEDICAL CENTER
Practice Location Address:

751 LIBERTY ST
MEADVILLE, PA
16335-2559

Practice Phone: 814-333-5000
Practice Fax:

1205675550 — PAULA JO LYNCH LPC, ATR
Practice Location Address:

127 JEFFERSON ST
MEADVILLE, PA
16335-1108

Practice Phone: 814-350-1657
Practice Fax:

Directions to “CLINICAL PRACTICE OF LECOM INSTITUTE FOR SUCCESSFUL LIVING ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.