Mind Trek Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MIND TREK COUNSELING LLC

Practice address

2460 Fairmount Blvd Ste 209
Cleveland Heights, OH 44106-3125

Phone

(216) 777-9587

NPI assigned

May 2, 2021

Last updated

May 2, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shiyue Qin, LISWNPI 1871071415

Title

Owner

Phone

(216) 777-9587

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 2

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.

• Shiyue Qin, LISW

  • Clinical Social Worker
  • Cleveland Heights, OH
  • NPI 1871071415

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD Authorized official
• Kristen Elizabeth Ayers

  • Counselor
  • Bainbridge, OH
  • NPI 1154946028
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619913600000",
    "number": "1467035097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 FAIRMOUNT BLVD STE 209",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441063125",
            "telephone_number": "216-777-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 FAIRMOUNT BLVD STE 209",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441063125",
            "telephone_number": "216-777-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND TREK COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-02",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A",
        "authorized_official_last_name": "QIN",
        "authorized_official_first_name": "SHIYUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-777-9587",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Miller, PHARMD
• Holly Rae Miller, PHARMD
• Michael A Miller, LPCC
• Sandra Miller, CDCA
• Peter Milota, LISW
• Floro Deo Miraldi, MD
• Abigail Mary Mitchell, MA
• Clarence Mitchell
• Robert Allan Mitchell, LISW LICDC
• Sharon L Mitchell, PHD

• Clinical Social Worker in Cleveland Heights, OH
• Providers in Cleveland Heights, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2021; 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.