Active NPI
Michael Tod Scoville, CT
- Mental Health Counselor
- Niles, OH
National Provider Identifier
1336764539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C.2002366-TRNE
- Practice address
- 165 E Park Ave
Niles, OH 44446-2352 - Phone
- (330) 544-8005
- Fax
- (330) 544-9379
- NPI assigned
- Jun 12, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C.2002366-TRNE | OH | Primary |
Addresses
Primary practice location
165 E Park Ave
Niles, OH 44446-2352
Mailing address
23 Gordon St
Girard, OH 44420-1707
Phone (234) 600-0672
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.2002366-TRNE | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cadence Care Network | Current | Accepting new patients | |
| Cadence Care Network | Current | Accepting new patients |
Locations
165 E Park Ave
Niles, OH 44446
Phone (330) 544-8005
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 2
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.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Niles, OH
- NPI 1053928416
-
- Adolescent and Children Mental Health Clinic/Center
- Niles, OH
- NPI 1558339762
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591920000000",
"number": "1336764539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 GORDON ST",
"city": "GIRARD",
"state": "OH",
"postal_code": "444201707",
"telephone_number": "234-600-0672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 E PARK AVE",
"city": "NILES",
"state": "OH",
"postal_code": "444462352",
"telephone_number": "330-544-8005",
"fax_number": "330-544-9379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOVILLE",
"first_name": "MICHAEL",
"middle_name": "TOD",
"credential": "CT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-12",
"last_updated": "2020-06-12",
"certification_date": "2020-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "C.2002366-TRNE",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Niles, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.