NPIMap

Organization Active NPI

Holding Space LLC

Doing business as Tiffany Manrodt

  • Psychiatry Physician
  • Westlake, OH
National Provider Identifier
1033772421
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
HOLDING SPACE LLC
Doing business as
Tiffany Manrodt
Practice address
24481 Detroit Rd Ste 201
Westlake, OH 44145-1557
Phone
(440) 310-6361
Fax
(440) 625-2592
NPI assigned
Apr 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Authorized official

Name
Tiffany Manrodt, LISW-SNPI 1326557836
Title
Clinical Director, Lisw
Phone
(440) 226-6531

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

24481 Detroit Rd Ste 201
Westlake, OH 44145-1557

Mailing address

24481 Detroit Rd Ste 201
Westlake, OH 44145-1557
Phone (440) 310-6361

Other names 1

  • Tiffany Manrodt Doing business as

National Provider Directory

National Provider Directory

Locations

8927 Brecksville Rd
Brecksville, OH 44141
Phone (440) 310-6361

24481 Detroit Rd
Ste 201
Westlake, OH 44145
Phone (440) 310-6361

26404 Center Ridge Rd
Ste 7
Westlake, OH 44145

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1555804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651622400000",
    "number": "1033772421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24481 DETROIT RD STE 201",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451557",
            "telephone_number": "440-310-6361",
            "fax_number": "440-625-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24481 DETROIT RD STE 201",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451557",
            "telephone_number": "440-310-6361",
            "fax_number": "440-625-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLDING SPACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-21",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A",
        "authorized_official_last_name": "MANRODT",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR, LISW",
        "authorized_official_telephone_number": "440-226-6531",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tiffany Manrodt",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tiffany Manrodt",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.