Individual provider Active NPI

Taryn Jessica Ponsky, LPC

  • Mental Health Counselor
  • Shaker Heights, OH
National Provider Identifier
1053532663
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.0500986 Issued in OH
Practice address
19910 Malvern Rd
Shaker Heights, OH 44122
Phone
(216) 991-4472
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.0500986 OH Primary

Addresses

Primary practice location

19910 Malvern Rd
Shaker Heights, OH 44122

Mailing address

2370 Woodmere Drive
Cleveland Heights, OH 44106-4410
Phone (216) 321-1909

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
I20240304001428 OH Practitioner - Mental Health Counselor 4082059704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Coast Mental Health Associates IncGroup PAC ID 5597661439, 10 clinicians

Practice addresses (Care Compare)

3690 Orange PL
Suite 430
Beachwood, OH 44122-4467
Phone (216) 464-5330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.0500986OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
North Coast Mental Health Associates Inc. CurrentSince Jan 3, 2024 Accepting new patients

Locations

3690 Orange Pl
Ste 430
Beachwood, OH 44122
Phone (216) 464-5330

Organizations & group practices 1

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053532663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 WOODMERE DRIVE",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441064410",
            "telephone_number": "216-321-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19910 MALVERN RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-991-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONSKY",
        "first_name": "TARYN",
        "middle_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.0500986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

Verify at the official NPI Registry.