Lodge, Tania

Lodge, Tania is an individual health care provider with primary practice located at 3618 W Market St Ste 15 , Fairlawn OH 44333-2425. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Lodge, Tania can be contacted via phone (234) 466-0445.

Contact Information

Primary practice address
3618 W Market St Ste 15 Fairlawn OH 44333-2425
Phone: (234) 466-0445
Fax: (234) 466-0359
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X E.0500437 Ohio
Behavioral Health & Social Service Providers / Clinical 103TC0700X P.08616 Ohio

Profile Details

NPI number 1437315520
LBN Legal business name Lodge, Tania
Credentials PHD, PCC-S
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2008
Last updated Apr 16th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437315520 NPPES
Ohio MEDICAID 0214582

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