Provider Demographics
NPI:1285938779
Name:HOROWITZ, LEE JERALD (PHD)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:JERALD
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3659 GREEN RD
Mailing Address - Street 2:218
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5727
Mailing Address - Country:US
Mailing Address - Phone:216-831-2700
Mailing Address - Fax:216-831-2702
Practice Address - Street 1:3659 GREEN RD
Practice Address - Street 2:SUITE 218
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5727
Practice Address - Country:US
Practice Address - Phone:216-831-2700
Practice Address - Fax:216-831-2702
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH269103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist