Phoenix Mussalow, MA, LPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.1600825 Issued in OH

Practice address

2562 Graham Rd
Stow, OH 44224-3504

Phone

(276) 200-8769

NPI assigned

Apr 20, 2017

Reactivated

Aug 5, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 5, 2024 through Feb 5, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/summit-psychological/r4/

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.

• Lora Hoffstetter and Counseling Associates, LLC

  • Mental Health Counselor
  • Hudson, OH
  • NPI 1124321492
  NPD (past)
• Summit Psychological Associates, Inc.

  • Clinical Psychologist
  • Akron, OH
  • NPI 1114976701
  NPD (past)

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1245765874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6693 N CHESTNUT ST STE 235",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663900",
            "telephone_number": "330-296-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2562 GRAHAM RD",
            "city": "STOW",
            "state": "OH",
            "postal_code": "442243504",
            "telephone_number": "276-200-8769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSALOW",
        "first_name": "PHOENIX",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-20",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "deactivation_date": "2017-08-09",
        "reactivation_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1600825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Morris
• Cheryl Morse
• Mary Bernadette Moxley
• John Howard Murphy, D.D.S.
• Joseph Norman Murray, PH.D.
• Melissa R Myers, CNP
• Thomas C Myers, D.O.
• Nizar Nader, MD
• Joseph Najdovski, PT, DPT
• Pranav Nampoothiripad

• Mental Health Counselor in Stow, OH
• Providers in Stow, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.