Active NPI
Tina Renee Clay
- Peer Specialist
- Lorain, OH
National Provider Identifier
1245102466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- APS.005630
- Practice address
- 6061 S Broadway
Lorain, OH 44053-3818 - Phone
- (440) 375-5342
- Fax
- (440) 637-0330
- NPI assigned
- Sep 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | APS.005630 | OH | Primary |
Addresses
Primary practice location
6061 S Broadway
Lorain, OH 44053-3818
Mailing address
6061 S Broadway
Lorain, OH 44053-3818
Phone (440) 375-5342
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
| License | State | Type | Specialty |
|---|---|---|---|
| APS.005630 | OH | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1245102466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6061 S BROADWAY",
"city": "LORAIN",
"state": "OH",
"postal_code": "440533818",
"telephone_number": "440-375-5342",
"fax_number": "440-637-0330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6061 S BROADWAY",
"city": "LORAIN",
"state": "OH",
"postal_code": "440533818",
"telephone_number": "440-375-5342",
"fax_number": "440-637-0330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLAY",
"first_name": "TINA",
"middle_name": "RENEE",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-18",
"last_updated": "2025-09-18",
"certification_date": "2025-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OH",
"license": "APS.005630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.