Individual provider Active NPI

Carly Grabowski

  • Professional Counselor
  • Cleveland, OH
National Provider Identifier
1043769565
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C.1500184 Issued in OH
Practice address
4269 Pearl Rd
Cleveland, OH 44109-4234
Phone
(216) 431-4131
Fax
(216) 431-4151
NPI assigned
Sep 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C.1500184 OH Primary

Addresses

Primary practice location

4269 Pearl Rd
Cleveland, OH 44109-4234

Mailing address

9286 Province LN
Brecksville, OH 44141-1781
Phone (440) 669-0435

Other identifiers 1

IdentifierTypeStateIssuer
0347060MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240703001038 OH Practitioner - Mental Health Counselor 1557805397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imagining the Garden LLCGroup PAC ID 2365986189, 4 clinicians

Practice addresses (Care Compare)

7650 Chippewa Rd
Suite 310
Brecksville, OH 44141-2319
Phone (216) 716-7777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1500184OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Imagining the Garden LLC CurrentSince May 1, 2024 Accepting new patients
Center for Effective Living Inc. PastSince Nov 22, 2020 Accepting new patients

Locations

7650 Chippewa Rd
Ste 310
Brecksville, OH 44141
Phone (216) 716-7777

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1043769565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9286 PROVINCE LN",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441411781",
            "telephone_number": "440-669-0435",
            "fax_number": "440-717-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4269 PEARL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441094234",
            "telephone_number": "216-431-4131",
            "fax_number": "216-431-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABOWSKI",
        "first_name": "CARLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-26",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1500184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0347060",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.