Cleveland State University Health and Wellness Services

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

Legal business name

CLEVELAND STATE UNIVERSITY HEALTH AND WELLNESS SERVICES

Practice address

2121 Euclid Ave
Un 263
Cleveland, OH 44115-2214

Phone

(216) 687-3649

Fax

(216) 687-9319

NPI assigned

Nov 16, 2005

Organization subpart

No

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

Authorized official

Name

Eileen Guttman, CNP

Title

Supervisor

Phone

(216) 687-3649

Specialties & licenses 1

Addresses

Other identifiers 3

Tax ID family

Cleveland State University2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Cleveland State University

  • Student Health Clinic/Center
  • Cleveland, OH
  • NPI 1164704995
  NPD tax ID

Locations

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1023090974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 EUCLID AVE",
            "address_2": "UN 263",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152214",
            "telephone_number": "216-687-3649",
            "fax_number": "216-687-9319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 EUCLID AVE",
            "address_2": "UN 263",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152214",
            "telephone_number": "216-687-3649",
            "fax_number": "216-687-9319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND STATE UNIVERSITY HEALTH AND WELLNESS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "GUTTMAN",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "216-687-3649",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2329019",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "36D0874476",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARM LICENSE #",
            "identifier": "02-0251800",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cleveland Sleep Treatment LLC
• Cleveland Society for the Blind
• Cleveland Society for the Blind
• Cleveland Sports Academy
• Cleveland State University
• Cleveland State University Speech and Hearing Clinic
• Cleveland Team Construction
• Cleveland Telehealth LLC
• Cleveland Transportation Connection LLC
• Cleveland Umadaop Treatment and Recovery Services

• All providers in Cleveland, OH
• Student Health Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.