Individual provider Active NPI

Aravia Eve Bickerstaff

  • Adult Mental Health Clinic/Center
  • Akron, OH
National Provider Identifier
1013668516
Registry record updated Jan 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Practice address
1514 Tyler St
Akron, OH 44307-1039
Phone
(330) 801-9933
NPI assigned
Jan 16, 2022
Last updated
Jan 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1514 Tyler St
Akron, OH 44307-1039

Mailing address

1514 Tyler St
Akron, OH 44307-1039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1642291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642291200000",
    "number": "1013668516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 TYLER ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443071039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 TYLER ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443071039",
            "telephone_number": "330-801-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICKERSTAFF",
        "first_name": "ARAVIA",
        "middle_name": "EVE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-16",
        "last_updated": "2022-01-16",
        "certification_date": "2022-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.