Individual provider Active NPI

Katy Flegal, M.S., LCDC III

  • Addiction (Substance Use Disorder) Counselor
  • Cleveland, OH
National Provider Identifier
1295127702
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
141297 Issued in OH
Practice address
30800 Chagrin Blvd
Cleveland, OH 44124-5925
Phone
(216) 292-2073
Fax
(216) 591-1243
NPI assigned
Feb 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 141297 OH Primary

Addresses

Primary practice location

30800 Chagrin Blvd
Cleveland, OH 44124-5925

Mailing address

30800 Chagrin Blvd
Cleveland, OH 44124-5925
Phone (216) 292-2073

Other identifiers 1

IdentifierTypeStateIssuer
2374229MedicaidOH

Other names 1

  • Katy R Hauris Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
141297OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Redefined Counseling and Consulting Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1424476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1295127702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30800 CHAGRIN BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441245925",
            "telephone_number": "216-292-2073",
            "fax_number": "216-591-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30800 CHAGRIN BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441245925",
            "telephone_number": "216-292-2073",
            "fax_number": "216-591-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEGAL",
        "first_name": "KATY",
        "credential": "M.S., LCDC III",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-21",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "141297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2374229",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATY",
            "last_name": "HAURIS",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.