Project Lift Behavioral Health Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PROJECT LIFT BEHAVIORAL HEALTH SERVICES

Practice address

4415 Euclid Ave Ste 315
Cleveland, OH 44103-3759

Phone

(216) 789-0942

Fax

(216) 918-4308

NPI assigned

Dec 23, 2020

Organization subpart

No

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

Authorized official

Name

Latoya Logan, MSSA LISW-SNPI 1174825632

Title

Executive Director

Phone

(216) 789-0942

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Latoya Logan, LISW-S

  • Clinical Social Worker
  • Beachwood, OH
  • NPI 1174825632
  NPD Authorized official
• Corryn Nicole Freeman-Wells

  • Behavior Technician
  • Cleveland, OH
  • NPI 1356935274
  NPD
• Faizah Rahman, RA

  • Case Management Agency
  • Cleveland, OH
  • NPI 1306711700
  NPD
• Stacy Ward Braxton

  • Social Worker
  • Cleveland, OH
  • NPI 1407600588
  NPD

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

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627862400000",
    "number": "1326635475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 EUCLID AVE STE 315",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441033759",
            "telephone_number": "216-789-0942",
            "fax_number": "216-918-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 EUCLID AVE STE 315",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441033759",
            "telephone_number": "216-789-0942",
            "fax_number": "216-918-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT LIFT BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-23",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "LATOYA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "216-789-0942",
        "authorized_official_credential": "MSSA LISW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0325117",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "Electronic Records",
            "address_1": "4415 Euclid Ave Ste 315",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441033759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Hayley Prokay, SWT
• Natalia Kosha Prokop, LISW
• Promise Icf and Hospice LLC
• Lilia Pron, PMHNP-BC
• Eugene Pronty

• Community/Behavioral Health Agency in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Community/Behavioral Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2021; 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.