Provider Demographics
NPI:1932346384
Name:LAKEWOOD LOCAL SCHOOLS
Entity type:Organization
Organization Name:LAKEWOOD LOCAL SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-928-5878
Mailing Address - Street 1:525 E. MAIN STREET
Mailing Address - Street 2:PO BOX 70
Mailing Address - City:HEBRON
Mailing Address - State:OH
Mailing Address - Zip Code:43025
Mailing Address - Country:US
Mailing Address - Phone:740-928-5878
Mailing Address - Fax:740-928-3152
Practice Address - Street 1:525 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:OH
Practice Address - Zip Code:43025-9702
Practice Address - Country:US
Practice Address - Phone:740-928-5878
Practice Address - Fax:740-928-3152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP6574235Z00000X
OHSP6373235Z00000X
OHSP6465235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty