Individual provider Active NPI

Treacha Slattman, L.P.C.C., C.R.C

  • Mental Health Counselor
  • Mentor, OH
National Provider Identifier
1134558018
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2303756 Issued in OH
Practice address
7232 Justin Way
Mentor, OH 44060-4881
Phone
(440) 578-8200
NPI assigned
Nov 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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 101Y00000X
Mental Health Counselor 101YM0800X E.2303756 OH Primary

Addresses

Primary practice location

7232 Justin Way
Mentor, OH 44060-4881

Mailing address

7232 Justin Way
Mentor, OH 44060-4881
Phone (440) 578-8200

Other practice location 1

179 Broad St
Conneaut, OH 44030-2614
Phone (440) 488-8646

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
I20240111001197 OH Practitioner - Mental Health Counselor 7810348109 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Health Inc CurrentSince Jan 1, 2024 Accepting new patients
Signature Health, Inc. Mental Health Current Accepting new patients
Signature Health, Inc CurrentSince Jan 1, 2024 Accepting new patients
Baker Family Counseling, LLC Mental Health CurrentSince Mar 1, 2021 Accepting new patients
Karen Baluch, LPCC Baker Family Counseling Mental Health PastSince Mar 1, 2021 Accepting new patients

Locations

179 Broad St
Conneaut, OH 44030
Phone (440) 487-7930

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

38882 Mentor Ave
Willoughby, OH 44094

38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333

Organizations & group practices 5

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": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1134558018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7232 JUSTIN WAY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604881",
            "telephone_number": "440-578-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7232 JUSTIN WAY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604881",
            "telephone_number": "440-578-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "179 Broad St",
            "address_purpose": "LOCATION",
            "city": "Conneaut",
            "state": "OH",
            "postal_code": "440302614",
            "country_code": "US",
            "telephone_number": "440-488-8646",
            "fax_number": "440-201-6566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLATTMAN",
        "first_name": "TREACHA",
        "credential": "L.P.C.C., C.R.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-01",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "101Y00000X",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2303756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.