Individual provider Active NPI

Eileen M Pappalardo, PCC, ATR-BC

  • Mental Health Counselor
  • Cleveland, OH
National Provider Identifier
1225320690
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.1100164 Issued in OH
Practice address
1744 Payne Ave
Cleveland, OH 44114-2910
Phone
(216) 623-6555
NPI assigned
May 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.1100164 OH
Mental Health Counselor 101YM0800X E.1100164 OH Primary

Addresses

Primary practice location

1744 Payne Ave
Cleveland, OH 44114-2910

Mailing address

20525 Center Ridge Rd Ste 502
Rocky River, OH 44116-3424
Phone (440) 799-4717

Other identifiers 2

IdentifierTypeStateIssuer
0212816MedicaidOH
1447793583OtherOHSIMPLE PRESENCE COUNSELING, LLC

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

State licenses

LicenseStateTypeSpecialty
E.1100164OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Simple Presence Counseling, LLC Professional Current Accepting new patients

Locations

20525 Center Ridge Rd
Rocky River, OH 44116
Phone (216) 200-8814

20525 Center Ridge Rd
Ste 502
Rocky River, OH 44116
Phone (216) 228-3500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1225320690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20525 CENTER RIDGE RD STE 502",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163424",
            "telephone_number": "440-799-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 PAYNE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142910",
            "telephone_number": "216-623-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPALARDO",
        "first_name": "EILEEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PCC, ATR-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1100164",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.1100164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0212816",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIMPLE PRESENCE COUNSELING, LLC",
            "identifier": "1447793583",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.