Individual provider Active NPI

Charity A Cousin, CPRS

  • Peer Specialist
  • Youngstown, OH
National Provider Identifier
1356057178
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
25 N Canfield Niles Rd Ste 30
Youngstown, OH 44515-2308
Phone
(330) 542-6200
Fax
(833) 307-1913
NPI assigned
Jan 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

25 N Canfield Niles Rd Ste 30
Youngstown, OH 44515-2308

Mailing address

221 Crescent St Ste 202
Waltham, MA 02453-3425
Phone (781) 487-1107

Other practice location 1

5932 Springboro Pike
Dayton, OH 45449-3250
Phone (937) 637-0412

Other practice location 2

6100 E Main St Ste 102
Columbus, OH 43213-3399
Phone (380) 800-3428

Other practice location 3

789 White Pond Dr Ste C
Akron, OH 44320-4203
Phone (330) 840-5170

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

Practice roles

OrganizationSpecialtyStatusNew patients
Eleanor Health Professional Oh, LLC CurrentSince Feb 15, 2021 Accepting new patients

Locations

221 Crescent St
Ste 202
Waltham, MA 02453
Phone (617) 958-1611

789 White Pond Dr
Ste C
Akron, OH 44320
Phone (330) 355-3153

6100 E Main St
Ste 102
Columbus, OH 43213
Phone (380) 800-3428

5932 Springboro Pike
Dayton, OH 45449
Phone (937) 435-8663

25 N Canfield Niles Rd
Ste 30
Youngstown, OH 44515
Phone (330) 355-3153

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": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1356057178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 CRESCENT ST STE 202",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533425",
            "telephone_number": "781-487-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N CANFIELD NILES RD STE 30",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445152308",
            "telephone_number": "330-542-6200",
            "fax_number": "833-307-1913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5932 Springboro Pike",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454493250",
            "country_code": "US",
            "telephone_number": "937-637-0412",
            "fax_number": "833-437-1412",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6100 E Main St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432133399",
            "country_code": "US",
            "telephone_number": "380-800-3428",
            "fax_number": "833-645-2551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "789 White Pond Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443204203",
            "country_code": "US",
            "telephone_number": "330-840-5170",
            "fax_number": "833-629-0813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COUSIN",
        "first_name": "CHARITY",
        "middle_name": "A",
        "credential": "CPRS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.