Organization Active NPI

Lifeguide Health LLC

  • Mental Health Counselor
  • North Olmsted, OH
National Provider Identifier
1225628605
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LIFEGUIDE HEALTH LLC
Practice address
28922 Lorain Rd Ste 201
North Olmsted, OH 44070-4047
Phone
(440) 360-7500
NPI assigned
Jan 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Authorized official

Name
Thomas Forrester
Title
Owner
Phone
(440) 360-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

28922 Lorain Rd Ste 201
North Olmsted, OH 44070-4047

Mailing address

28922 Lorain Rd Ste 201
North Olmsted, OH 44070-4047
Phone (440) 360-7500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210218002121 OH Part B Supplier - Clinic/Group Practice 3678988953 Receives reassigned benefits from 6 practitioners
Practice locations: North Olmsted, OH; Westerville, OH

National Provider Directory

National Provider Directory

Locations

28922 Lorain Rd
Ste 201
North Olmsted, OH 44070
Phone (440) 360-7500

128 County Line Rd W
Ste D
Westerville, OH 43082
Phone (440) 360-7500

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1225628605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28922 LORAIN RD STE 201",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440704047",
            "telephone_number": "440-360-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28922 LORAIN RD STE 201",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440704047",
            "telephone_number": "440-360-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEGUIDE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-20",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "FORRESTER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-360-7500"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Olmsted, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.