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
Sex
Female
Sole proprietor
Yes

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

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

1514 Tyler St
Akron, OH 44307-1039

Mailing address

1514 Tyler St
Akron, OH 44307-1039

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 16, 2022.

{
    "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.