Individual provider Active NPI

Derricka C Barron

  • Counselor
  • Cleveland, OH
National Provider Identifier
1104304872
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
4269 Pearl Rd
Cleveland, OH 44109-4234
Phone
(216) 431-4131
NPI assigned
Aug 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OH
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Counselor 101Y00000X Primary

Addresses

Primary practice location

4269 Pearl Rd
Cleveland, OH 44109-4234

Mailing address

4269 Pearl Rd
Cleveland, OH 44109-4234
Phone (216) 431-4131

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
I20260217002245 OH Practitioner - Mental Health Counselor 0446694590 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Cincinnati, OH 45263

PO Box
Suite 632266
Cincinnati, OH 45263-2266

PO Box
Suite 638707
Cincinnati, OH 45263-8707

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PA Post Acute Services PC Multi-Specialty CurrentSince Dec 30, 2025 Accepting new patients
CNP Operating Co LLC Multi-Specialty CurrentSince Dec 23, 2025 Accepting new patients
Ohioguidestone Past Accepting new patients

Locations

8055 Addison Rd
Masury, OH 44438
Phone (330) 448-2547

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": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1104304872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4269 PEARL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441094234",
            "telephone_number": "216-431-4131"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRON",
        "first_name": "DERRICKA",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-03",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.