Stacey R Herrada, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

181170 Issued in OH

Practice address

14445 Broadway Ave
Cleveland, OH 44125-1957

Phone

(443) 542-7765

NPI assigned

Jan 31, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Legend Treatment Center of Cleveland, LLC

  • Community/Behavioral Health Agency
  • Cleveland, OH
  • NPI 1477342962
  NPD

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1376249490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 BROADWAY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441251957",
            "telephone_number": "443-542-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 BROADWAY AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441251957",
            "telephone_number": "443-542-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRADA",
        "first_name": "STACEY",
        "middle_name": "R",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "181170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamika Herndon
• Hero Group Home LLC
• Breanna Rose Herock, LPCC-S, LICDC
• Marcus Gurst Herod, MD
• Kathryn Herr
• Maria Isabel Herran, MD
• Tonya Herrell
• Jacob Herremans, DDS
• Jayson Philip Herrera, CRNA
• Anna Marie Herrick, CPNP

• Addiction (Substance Use Disorder) Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.