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24500 Center Ridge Rd Suite 185 Westlake OH 44145 | |
| (440) 219-3510 | |
| (440) 455-1410 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 24500 Center Ridge Rd, Westlake, Ohio |
| Authorized Official Name and Position | Benjamin Williams Kearney (OWNER) |
| Authorized Official Contact | 4402193510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8995 Wyllys Dr North Ridgeville OH 44039 Ph: (440) 219-3510 | 24500 Center Ridge Rd Suite 185 Westlake OH 44145 Ph: (440) 219-3510 |
| NPI Number | 1578765095 |
|---|---|
| Provider Enumeration Date | 06/05/2007 |
| Last Update Date | 06/09/2023 |
| Certification Date | 06/09/2023 |
| Medicare PECOS PAC ID | 4082744115 |
|---|---|
| Medicare Enrollment ID | O20100615000948 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578765095 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 2475 (Ohio) | Secondary |
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Benjamin Kearney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437205911 PECOS PAC ID: 8527198654 Enrollment ID: I20241008001316 |
| Provider Name | Thomas Cooper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346452323 PECOS PAC ID: 0941733471 Enrollment ID: I20241030003378 |
| Provider Name | Michael Paul Kearney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093846735 PECOS PAC ID: 7618007741 Enrollment ID: I20241118000719 |
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