| Four Directions Psychological Services, Llc | |
|
3454 Oak Alley Ct Ste 200 Toledo OH 43606-1370 | |
| (419) 460-0413 | |
| (844) 443-0075 |
| Full Name | Four Directions Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3454 Oak Alley Ct Ste 200, Toledo, Ohio |
| Authorized Official Name and Position | Laura Jean Lewis (OWNER) |
| Authorized Official Contact | 4194600413 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Directions Psychological Services, Llc 3454 Oak Alley Ct Ste 200 Toledo OH 43606-1370 Ph: (141) 946-0041 | Four Directions Psychological Services, Llc 3454 Oak Alley Ct Ste 200 Toledo OH 43606-1370 Ph: (419) 460-0413 |
| NPI Number | 1467111492 |
|---|---|
| Provider Enumeration Date | 12/17/2021 |
| Last Update Date | 12/17/2021 |
| Certification Date | 12/17/2021 |
| Medicare PECOS PAC ID | 9931591179 |
|---|---|
| Medicare Enrollment ID | O20220119002511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467111492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Laura J Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588998595 PECOS PAC ID: 8820265184 Enrollment ID: I20120127000239 |
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