Active NPI
Sonji Imani Kenyatta
- Counselor
- Shaker Heights, OH
National Provider Identifier
1275999484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- C.0700325
- Practice address
- 22001 Fairmount Blvd
Shaker Heights, OH 44118-4819 - Phone
- (216) 320-8925
- Fax
- (216) 932-2800
- NPI assigned
- Jan 5, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | C.0700325 | OH | Primary |
Addresses
Primary practice location
22001 Fairmount Blvd
Shaker Heights, OH 44118-4819
Mailing address
1323 Burlington Rd
Cleveland Heights, OH 44118-1212
Phone (216) 533-0134
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250912002144 | OH | Practitioner - Mental Health Counselor | 3971006156 | Practice locations: Cleveland Heights, OH |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2007
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1323 Burlington Rd
Cleveland Heights, OH 44118-1212
Phone (216) 533-0134
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.0700325 | OH | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451952000000",
"number": "1275999484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1323 BURLINGTON RD",
"city": "CLEVELAND HEIGHTS",
"state": "OH",
"postal_code": "441181212",
"telephone_number": "216-533-0134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22001 FAIRMOUNT BLVD",
"city": "SHAKER HEIGHTS",
"state": "OH",
"postal_code": "441184819",
"telephone_number": "216-320-8925",
"fax_number": "216-932-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENYATTA",
"first_name": "SONJI",
"middle_name": "IMANI",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-05",
"last_updated": "2016-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OH",
"license": "C.0700325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shaker Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.