Individual provider Active NPI

Brianna Rose Hazelet, LPCC

  • Mental Health Counselor
  • Avon Lake, OH
National Provider Identifier
1154918597
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2404566 Issued in OH
Practice address
215 Miller Rd Ste 7
Avon Lake, OH 44012-1013
Phone
(440) 742-1661
NPI assigned
Dec 30, 2020
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E.2404566 OH Primary

Addresses

Primary practice location

215 Miller Rd Ste 7
Avon Lake, OH 44012-1013

Mailing address

215 Miller Rd Ste 7
Avon Lake, OH 44012-1013
Phone (440) 742-1661

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
I20250224001697 OH Practitioner - Mental Health Counselor 9537689302 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.2404566OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Leaf Counseling Services LLC CurrentSince Dec 7, 2024 Accepting new patients

Locations

215 Miller Rd
Ste 7
Avon Lake, OH 44012
Phone (440) 742-1661

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1154918597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 MILLER RD STE 7",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121013",
            "telephone_number": "440-742-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MILLER RD STE 7",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121013",
            "telephone_number": "440-742-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELET",
        "first_name": "BRIANNA",
        "middle_name": "ROSE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2404566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon Lake, OH

Sources for this page

Verify at the official NPI Registry.