Individual provider Active NPI

Heather Rebeck, QMHS

  • Community/Behavioral Health Agency
  • Ravenna, OH
National Provider Identifier
1194281220
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
310 Bennett Ave
Ravenna, OH 44266-3211
Phone
(330) 839-9966
NPI assigned
Feb 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

310 Bennett Ave
Ravenna, OH 44266-3211

Mailing address

5545 Smith Road
Brook Park, OH 44142

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": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1194281220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5545 SMITH ROAD",
            "city": "BROOK PARK",
            "state": "OH",
            "postal_code": "44142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 BENNETT AVE",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663211",
            "telephone_number": "330-839-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBECK",
        "first_name": "HEATHER",
        "credential": "QMHS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-13",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.