Individual provider Active NPI

Korinne Stanich, LPCC

  • Professional Counselor
  • Willoughby Hills, OH
National Provider Identifier
1316089675
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0500215 Issued in OH
Practice address
34900 Chardon Rd
Willoughby Hills, OH 44094-9161
Phone
(440) 951-5600
NPI assigned
Feb 13, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C.0500215.TEMP OH
Professional Counselor 101YP2500X E.0500215 OH Primary

Addresses

Primary practice location

34900 Chardon Rd
Willoughby Hills, OH 44094-9161

Mailing address

8249 Lancaster Dr
Mentor, OH 44060-4247
Phone (216) 990-6224

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240702004278 OH Practitioner - Mental Health Counselor 7911441811 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.0500215.TEMPOHMDProfessional Counselor
E.0500215OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Glovan Pollak and Associates LLC CurrentSince Jun 3, 2024 Accepting new patients

Locations

8224 Mentor Ave
Ste 208
Mentor, OH 44060
Phone (440) 392-2222

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1316089675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8249 LANCASTER DR",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604247",
            "telephone_number": "216-990-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34900 CHARDON RD",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949161",
            "telephone_number": "440-951-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANICH",
        "first_name": "KORINNE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.0500215.TEMP",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0500215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby Hills, OH

Sources for this page

Verify at the official NPI Registry.