Individual provider Active NPI

Sergey Ostrovskiy

  • Mental Health Counselor
  • Cleveland, OH
National Provider Identifier
1174022982
Registry record updated Feb 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
S.1700100 Issued in OH
Practice address
5162 Broadway Ave
Cleveland, OH 44127-1571
Phone
(216) 938-6829
NPI assigned
Feb 7, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2018

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 S.1700100 OH Primary

Addresses

Primary practice location

5162 Broadway Ave
Cleveland, OH 44127-1571

Mailing address

5162 Broadway Ave
Cleveland, OH 44127-1571
Phone (216) 938-6829

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
I20220513001958 OH Practitioner - Clinical Social Worker 1951788819 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1700100OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Health, Inc CurrentSince May 9, 2022 Accepting new patients
Signature Health Inc CurrentSince May 9, 2022 Accepting new patients
Signature Health, Inc. Mental Health Current Accepting new patients
Community Assessment and Treatment Services, Inc Past Accepting new patients

Locations

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 4

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": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517961600000",
    "number": "1174022982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5162 BROADWAY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271571",
            "telephone_number": "216-938-6829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5162 BROADWAY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271571",
            "telephone_number": "216-938-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTROVSKIY",
        "first_name": "SERGEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-07",
        "last_updated": "2018-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "S.1700100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.