Individual provider Active NPI

Amber Keane

  • Mental Health Counselor
  • Chardon, OH
National Provider Identifier
1467944942
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
695 South St Ste 6
Chardon, OH 44024-1474
Phone
(440) 286-1553
NPI assigned
May 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

695 South St Ste 6
Chardon, OH 44024-1474

Mailing address

695 South St Ste 6
Chardon, OH 44024-1474
Phone (440) 286-1553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240430000486 OH Practitioner - Mental Health Counselor 0345680906 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Pride of Northeast Ohio Incorporated CurrentSince Mar 25, 2024 Accepting new patients
Family Pride of Northeast Ohio Incorporated Past Accepting new patients

Locations

695 South St
Ste 6
Chardon, OH 44024
Phone (440) 286-1553

521 5th Ave
Ste A
Chardon, OH 44024
Phone (440) 286-1553

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/familyprideonline/r4/

Organizations & group practices 2

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": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1467944942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 SOUTH ST STE 6",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241474",
            "telephone_number": "440-286-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 SOUTH ST STE 6",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241474",
            "telephone_number": "440-286-1553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEANE",
        "first_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

Verify at the official NPI Registry.