Organization Active NPI

Guiding Light Holistic Center Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1346860202
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GUIDING LIGHT HOLISTIC CENTER INC
Practice address
3100 E 45TH St Ste 234
Cleveland, OH 44127-1091
Phone
(614) 636-5842
Fax
(614) 526-5949
NPI assigned
Apr 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Authorized official

Name
Kristin Aguado, NPNPI 1659777308
Title
Owner
Phone
(614) 636-5842

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

3100 E 45TH St Ste 234
Cleveland, OH 44127-1091

Mailing address

3100 E 45TH St Ste 234
Cleveland, OH 44127-1091
Phone (614) 636-5842

Other practice location 1

20 S 3rd St Ste 210
Columbus, OH 43215-4206
Phone (614) 636-5842

Other practice location 2

2333 Alexandria Dr
Lexington, KY 40504-3215
Phone (614) 636-5842

Other practice location 3

4449 Easton Way Fl 2
Columbus, OH 43219-7005
Phone (614) 636-5842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200602002924 OH Part B Supplier - Clinic/Group Practice 1557782315 Receives reassigned benefits from 1 practitioner
Practice locations: Cleveland, OH; Columbus, OH

National Provider Directory

National Provider Directory

Locations

3100 E 45th St
Ste 234233
Cleveland, OH 44127

4449 Easton Way
Ste 2026
Columbus, OH 43219

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587427200000",
    "number": "1346860202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 E 45TH ST STE 234",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271091",
            "telephone_number": "614-636-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E 45TH ST STE 234",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271091",
            "telephone_number": "614-636-5842",
            "fax_number": "614-526-5949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 S 3rd St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154206",
            "country_code": "US",
            "telephone_number": "614-636-5842",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2333 Alexandria Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405043215",
            "country_code": "US",
            "telephone_number": "614-636-5842",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4449 Easton Way Fl 2",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432197005",
            "country_code": "US",
            "telephone_number": "614-636-5842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GUIDING LIGHT HOLISTIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-21",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A",
        "authorized_official_last_name": "AGUADO",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-636-5842",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.