NPIMap

Organization Active NPI

Portage Path Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Akron, OH
National Provider Identifier
1225087802
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PORTAGE PATH COMMUNITY MENTAL HEALTH CENTER
Practice address
340 S Broadway St
Akron, OH 44308-1529
Phone
(330) 253-3100
Fax
(330) 253-5248
NPI assigned
May 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Authorized official

Name
Mrs. Tracy Yaeger, PHDNPI 1710073796
Title
President
Phone
(330) 253-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

340 S Broadway St
Akron, OH 44308-1529

Mailing address

340 S Broadway St
Akron, OH 44308-1529
Phone (330) 253-3100

Other identifiers 1

IdentifierTypeStateIssuer
2314561MedicaidOH

Other names 1

  • Portage Path Behavioral health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031230000716 OH Part B Supplier - Clinic/Group Practice 5597663344 Receives reassigned benefits from 68 practitioners
1 other NPI on this enrollment
Practice locations: Cuyahoga Falls, OH; Barberton, OH; Akron, OH

National Provider Directory

National Provider Directory
Tax ID family
Portage Path Community Mental Health Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

105 5th St SE
Ste 6
Barberton, OH 44203
Phone (330) 745-0081

792 Graham Rd
Ste C
Cuyahoga Falls, OH 44221
Phone (330) 253-3100

133 Wilbur Dr NE
North Canton, OH 44720
Phone (330) 494-6012

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 137

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 137

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483660800000",
    "number": "1225087802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 S BROADWAY ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081529",
            "telephone_number": "330-253-3100",
            "fax_number": "330-253-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 S BROADWAY ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081529",
            "telephone_number": "330-253-3100",
            "fax_number": "330-253-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE PATH COMMUNITY MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2017-01-06",
        "status": "A",
        "authorized_official_last_name": "YAEGER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-253-3100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2314561",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portage Path Behavioral health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.