NPIMap

Organization Active NPI

Kindred Spirit Behavioral Health

  • Community/Behavioral Health Agency
  • Fairlawn, OH
National Provider Identifier
1396493185
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
KINDRED SPIRIT BEHAVIORAL HEALTH
Practice address
3618 W Market St # E15
Fairlawn, OH 44333-2425
Phone
(234) 466-0445
NPI assigned
Mar 11, 2022
Last updated
Sep 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Authorized official

Name
Dr. Tania S Lodge, PHDNPI 1437315520
Title
Clinical Director
Phone
(234) 466-0445

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

3618 W Market St # E15
Fairlawn, OH 44333-2425

Mailing address

PO Box 4036
Copley, OH 44321-0036
Phone (330) 271-6160

Other practice location 1

545 Noble Ave
Akron, OH 44320-2950
Phone (330) 271-6160

Other identifiers 1

IdentifierTypeStateIssuer
0478831MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drtanialodge@kno2.com

National Provider Directory

National Provider Directory
Tax ID family
Kindred Spirit Behavioral Health3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1396493185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4036",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443210036",
            "telephone_number": "330-271-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3618 W MARKET ST # E15",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443332425",
            "telephone_number": "234-466-0445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Noble Ave",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443202950",
            "country_code": "US",
            "telephone_number": "330-271-6160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KINDRED SPIRIT BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "LODGE",
        "authorized_official_first_name": "TANIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "234-466-0445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0478831",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drtanialodge@kno2.com",
            "affiliation": "N",
            "address_1": "3618 W Market St # E15",
            "city": "Fairlawn",
            "state": "OH",
            "country_code": "US",
            "postal_code": "443332425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.