Individual provider Active NPI

Allison Anne Loeb-Munson

  • Mental Health Counselor
  • Chardon, OH
National Provider Identifier
1104183920
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2002000 Issued in OH
Practice address
695 South St Ste 6
Chardon, OH 44024-1474
Phone
(440) 286-1553
NPI assigned
Apr 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.1200088TRNE OH
Mental Health Counselor 101YM0800X E.2002000 OH Primary

Addresses

Primary practice location

695 South St Ste 6
Chardon, OH 44024-1474

Mailing address

695 South St Ste 6
Chardon, OH 44024-1474
Phone (440) 286-1553

Other practice location 1

8500 Station St Ste 285
Mentor, OH 44060-4972
Phone (440) 251-9325

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
I20240503002512 OH Practitioner - Mental Health Counselor 7618317835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Pride of Northeast Ohio IncorporatedGroup PAC ID 9739458589, 11 clinicians

Practice addresses (Care Compare)

521 5TH Ave
Suite a
Chardon, OH 44024-1088
Phone (440) 286-1553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1200088TRNEOHMDMental Health Counselor
E.2002000OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Pride of Northeast Ohio Incorporated CurrentSince Mar 31, 2024 Accepting new patients
Family Pride of Northeast Ohio Incorporated PastSince Mar 7, 2021 Accepting new patients

Locations

1110 Lake Ave
Ashtabula, OH 44004
Phone (440) 536-5680

695 South St
Ste 6
Chardon, OH 44024
Phone (440) 286-1553

521 5th Ave
Ste A
Chardon, OH 44024
Phone (440) 286-1553

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/familyprideonline/r4/

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1104183920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 SOUTH ST STE 6",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241474",
            "telephone_number": "440-286-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 SOUTH ST STE 6",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241474",
            "telephone_number": "440-286-1553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8500 Station St Ste 285",
            "address_purpose": "LOCATION",
            "city": "Mentor",
            "state": "OH",
            "postal_code": "440604972",
            "country_code": "US",
            "telephone_number": "440-251-9325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOEB-MUNSON",
        "first_name": "ALLISON",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1200088TRNE",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2002000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

Verify at the official NPI Registry.