Active NPI
Raleighsha Shelissa Samuels
- Case Manager/Care Coordinator
- Cleveland, OH
National Provider Identifier
1114702578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 12323 Castlewood Ave
Cleveland, OH 44108-3919 - Phone
- (216) 307-0428
- NPI assigned
- Aug 25, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 9
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | OH | ||
| Driver | 172A00000X | |||
| Community Health Worker | 172V00000X | OH | ||
| Peer Specialist | 175T00000X | OH | ||
| Case Management Agency | 251B00000X | OH | ||
| Non-Surgical Family Planning Clinic/Center | 261QF0050X | OH | ||
| Doula | 374J00000X | |||
| Home Health Aide | 374U00000X | |||
| Case Manager/Care Coordinator | 171M00000X | OH | Primary |
Addresses
Primary practice location
12323 Castlewood Ave
Cleveland, OH 44108-3919
Mailing address
12323 Castlewood Ave
Cleveland, OH 44108-3919
Phone (216) 307-0428
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732492800000",
"number": "1114702578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12323 CASTLEWOOD AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441083919",
"telephone_number": "216-307-0428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12323 CASTLEWOOD AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441083919",
"telephone_number": "216-307-0428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELS",
"first_name": "RALEIGHSHA",
"middle_name": "SHELISSA",
"name_prefix": "Prof.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-25",
"last_updated": "2024-11-25",
"certification_date": "2024-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "261QF0050X",
"taxonomy_group": "",
"desc": "Clinic/Center, Family Planning, Non-Surgical",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.