Individual provider Active NPI

Sandra Lee Suppan, MAED, LPCC

  • Professional Counselor
  • Akron, OH
National Provider Identifier
1073692331
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E1885-S Issued in OH
Practice address
312 Locust St
Akron, OH 44302-1801
Phone
(330) 762-0591
Fax
(330) 762-2242
NPI assigned
Nov 6, 2006
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
Professional Counselor 101YP2500X E1885-S OH Primary

Addresses

Primary practice location

312 Locust St
Akron, OH 44302-1801

Mailing address

87 N Canton Rd
Akron, OH 44305-3838
Phone (330) 794-4254

Other names 1

  • Miss Sandra Lee Anglin Former name

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
I20240617002213 OH Practitioner - Mental Health Counselor 9638612872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18 N Forge St
Akron, OH 44304-1317
Phone (330) 762-0591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E1885-SOHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Akron Children's Hospital Current Accepting new patients
Child Guidance & Family Solutions CurrentSince Apr 28, 2024 Accepting new patients
Child Guidance & Family Solutions PastSince Apr 28, 2024 Accepting new patients

Locations

87 N Canton Rd
Akron, OH 44305
Phone (330) 733-7993

18 N Forge St
Akron, OH 44304
Phone (330) 762-0591

524 W Park Ave
Barberton, OH 44203
Phone (330) 753-1096

Interoperability endpoints

  • Direct secure messaging: ssuppan122035@direct.chmca.org

Organizations & group practices 3

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073692331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 N CANTON RD",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443053838",
            "telephone_number": "330-794-4254",
            "fax_number": "330-794-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 LOCUST ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443021801",
            "telephone_number": "330-762-0591",
            "fax_number": "330-762-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPPAN",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "MAED, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E1885-S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "ANGLIN",
            "middle_name": "LEE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.