NPIMap

Organization Active NPI

State of Ohio Department of Mental Health

  • Case Management Agency
  • Akron, OH
National Provider Identifier
1104895176
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
STATE OF OHIO DEPARTMENT OF MENTAL HEALTH
Practice address
157 W Cedar St
Suite B
Akron, OH 44307-2564
Phone
(330) 467-7131
Fax
(330) 467-2420
NPI assigned
Mar 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Ms. Tonya Marie Fasone
Title
Fiscal Manager
Phone
(614) 466-9930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X OH Primary

Addresses

Primary practice location

157 W Cedar St
Suite B
Akron, OH 44307-2564

Mailing address

30 E. Broad St
11TH Floor - Fiscal Administration
Columbus, OH 43215-3430
Phone (614) 466-6583

Other identifiers 2

IdentifierTypeStateIssuer
10408OtherOHMACSIS
2452804MedicaidOH

Other names 1

  • NB - Summit Community Treatment Team CSN Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031202000209 OH Part B Supplier - Clinic/Group Practice 0143133181 Receives reassigned benefits from 261 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Northfield, OH; Youngstown, OH; Toledo, OH; Tiffin, OH; Mt Vernon, OH; Mineral Ridge, OH; Massillon, OH; Huber Heights, OH…

National Provider Directory

National Provider Directory

Locations

157 W Cedar St
Ste B
Akron, OH 44307
Phone (330) 467-7131

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1104895176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E. BROAD ST",
            "address_2": "11TH FLOOR - FISCAL ADMINISTRATION",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432153430",
            "telephone_number": "614-466-6583",
            "fax_number": "614-644-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 W CEDAR ST",
            "address_2": "SUITE B",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443072564",
            "telephone_number": "330-467-7131",
            "fax_number": "330-467-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF OHIO DEPARTMENT OF MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "FASONE",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "FISCAL MANAGER",
        "authorized_official_telephone_number": "614-466-9930",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MACSIS",
            "identifier": "10408",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2452804",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NB - Summit Community Treatment Team CSN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.