92ND Street Psych LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

92ND STREET PSYCH LLC

Practice address

72 N Main St Ste 207
Hudson, OH 44236-2867

Phone

(330) 294-4408

NPI assigned

Mar 5, 2025

Last updated

Apr 15, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bianca Olivera

Title

Practice Manager

Phone

(330) 294-4408

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth Hendrickson Carroll, RN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Hudson, OH
  • NPI 1356636914
  Medicare reassignment NPD
• Naomi House, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Canton, OH
  • NPI 1437818945
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1741132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1003614181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 N MAIN ST STE 207",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442362867",
            "telephone_number": "330-294-4408",
            "fax_number": "234-269-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 N MAIN ST STE 207",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442362867",
            "telephone_number": "330-294-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "92ND STREET PSYCH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-05",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "OLIVERA",
        "authorized_official_first_name": "BIANCA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "330-294-4408"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• ABA Behavioral Specialists
• Justin Acri, PHARMD
• Jenna Adams, RDN, LDN
• Nicole Marie Adkins, CNP
• Advanced Health Systems, Inc.

• Multi-Specialty Clinic/Center in Hudson, OH
• Providers in Hudson, OH by specialty
• Multi-Specialty Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.