| Debalzo Elgudin Levine Risen Llc | |
|
23425 Commerce Park Suite 104 Beachwood OH 44122-5844 | |
| (216) 831-2900 | |
| (216) 831-4306 |
| Full Name | Debalzo Elgudin Levine Risen Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 23425 Commerce Park, Beachwood, Ohio |
| Authorized Official Name and Position | Larissa Elgudin (CO-DIRECTOR) |
| Authorized Official Contact | 2168312900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Debalzo Elgudin Levine Risen Llc 23425 Commerce Park Suite 104 Beachwood OH 44122-5844 Ph: (216) 831-2900 | Debalzo Elgudin Levine Risen Llc 23425 Commerce Park Suite 104 Beachwood OH 44122-5844 Ph: (216) 831-2900 |
| NPI Number | 1396286191 |
|---|---|
| Provider Enumeration Date | 03/13/2017 |
| Last Update Date | 03/13/2017 |
| Medicare PECOS PAC ID | 3072880715 |
|---|---|
| Medicare Enrollment ID | O20170530001838 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396286191 | NPI | - | NPPES |
| Provider Name | Anna R Novak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821198359 PECOS PAC ID: 2264421866 Enrollment ID: I20040510000347 |
| Provider Name | Larissa Elgudin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629004387 PECOS PAC ID: 2163498858 Enrollment ID: I20040903000387 |
| Provider Name | Lois L Nicholson |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1457440257 PECOS PAC ID: 2062463193 Enrollment ID: I20050207000556 |
| Provider Name | Linda M Debalzo |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1639283518 PECOS PAC ID: 0840397048 Enrollment ID: I20070523000368 |
| Provider Name | Robert J Ronis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760408124 PECOS PAC ID: 6204920978 Enrollment ID: I20070926000233 |
| Provider Name | Stephen B Levine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659479038 PECOS PAC ID: 4587839501 Enrollment ID: I20111202000305 |
| Provider Name | Jeffrey A Karp |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205250347 PECOS PAC ID: 6901192871 Enrollment ID: I20160901002654 |
| Provider Name | Maria Sferro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386171601 PECOS PAC ID: 5698048486 Enrollment ID: I20210805002533 |
| Provider Name | Jessica Taibl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437747185 PECOS PAC ID: 2365848363 Enrollment ID: I20210830003090 |
| Provider Name | Jeffrey Iannone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164980934 PECOS PAC ID: 8921498908 Enrollment ID: I20211206002336 |
| Provider Name | Tanya Lynn Whitmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164013843 PECOS PAC ID: 3375930258 Enrollment ID: I20220422001500 |
| Provider Name | Erika Hayslip |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124763297 PECOS PAC ID: 7810379047 Enrollment ID: I20220803003473 |
| Provider Name | Brittany Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396258273 PECOS PAC ID: 3870963911 Enrollment ID: I20230105001511 |
| Provider Name | Sholom D Stern |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255622098 PECOS PAC ID: 8820447121 Enrollment ID: I20231212002876 |
| Provider Name | Rachel Berkowitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063281988 PECOS PAC ID: 2769821792 Enrollment ID: I20240423003106 |
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