Individual provider Active NPI

Eugenia Lyn Marett, CDCA

  • Case Manager/Care Coordinator
  • Cleveland, OH
National Provider Identifier
1447901228
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2525 E 22ND St
Cleveland, OH 44115-3202
Phone
(216) 932-2800
NPI assigned
Jan 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.2202672-TRNE OH
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.179005 OH
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

2525 E 22ND St
Cleveland, OH 44115-3202

Mailing address

19004 Pawnee Ave
Cleveland, OH 44119-1721
Phone (216) 324-4939

Other practice location 1

19004 Pawnee Ave
Cleveland, OH 44119-1721
Phone (216) 324-4939

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

LicenseStateTypeSpecialty
CDCA.179005OHMDAddiction (Substance Use Disorder) Counselor
S.2202672-TRNEOHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1447901228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19004 PAWNEE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441191721",
            "telephone_number": "216-324-4939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 E 22ND ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153202",
            "telephone_number": "216-932-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19004 Pawnee Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441191721",
            "country_code": "US",
            "telephone_number": "216-324-4939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARETT",
        "first_name": "EUGENIA",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2202672-TRNE",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.179005",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "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 Jun 18, 2024; 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.