Organization Active NPI

Western Reserve Counseling LLC

  • Counselor
  • Avon Lake, OH
National Provider Identifier
1275924391
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
E.0050965SUPV Issued in OH
Legal business name
WESTERN RESERVE COUNSELING LLC
Practice address
33448 Shelly CT
Avon Lake, OH 44012-1129
Phone
(440) 822-8248
Fax
(440) 377-6490
NPI assigned
Feb 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Mrs. Robin M Hale, LPCC, LICDCNPI 1841599248
Title
Provider
Phone
(440) 822-2248

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
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X E.0050965SUPV OH Primary

Addresses

Primary practice location

33448 Shelly CT
Avon Lake, OH 44012-1129

Mailing address

4773 Sisson Rd
Titusville, FL 32780-7227
Phone (440) 822-8248

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240129002299 OH Part B Supplier - Clinic/Group Practice 6800166372 Receives reassigned benefits from 1 practitioner
Practice locations: Avon Lake, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1275924391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4773 SISSON RD",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327807227",
            "telephone_number": "440-822-8248",
            "fax_number": "440-377-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33448 SHELLY CT",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121129",
            "telephone_number": "440-822-8248",
            "fax_number": "440-377-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN RESERVE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "440-822-2248",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPCC, LICDC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "OH",
            "license": "E.0050965SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon Lake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.