| Waltman Psychological Services Llc | |
|
3401 Enterprise Pkwy Ste 340 Beachwood OH 44122-7340 | |
| (216) 766-5730 | |
| (216) 766-5796 |
| Full Name | Waltman Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3401 Enterprise Pkwy Ste 340, Beachwood, Ohio |
| Authorized Official Name and Position | Douglas Waltman (OWNER) |
| Authorized Official Contact | 2167665730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waltman Psychological Services Llc 3401 Enterprise Pkwy Ste 340 Beachwood OH 44122-7340 Ph: (216) 766-5730 | Waltman Psychological Services Llc 3401 Enterprise Pkwy Ste 340 Beachwood OH 44122-7340 Ph: (216) 766-5730 |
| NPI Number | 1669008249 |
|---|---|
| Provider Enumeration Date | 03/16/2020 |
| Last Update Date | 03/16/2020 |
| Certification Date | 03/16/2020 |
| Medicare PECOS PAC ID | 1557790037 |
|---|---|
| Medicare Enrollment ID | O20200403002062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669008249 | NPI | - | NPPES |
| 0615650 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Douglas E Waltman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285850180 PECOS PAC ID: 2163682584 Enrollment ID: I20120322000180 |
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