Signature Health, Inc
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Willoughby, OH
NPI 1477575348 · NPPES record last updated Apr 11, 2025
Key facts
- NPI
- 1477575348
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- License
- 0467 (OH)
- Legal business name
- SIGNATURE HEALTH, INC
- Practice address
- 38876 Mentor Ave
Willoughby, OH 44094-7931 - Phone
- (440) 953-9999
- Fax
- (440) 918-3839
- NPI assigned
- Jul 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Jonathan Albert Lee
- Title
- Ceo
- Phone
- (440) 953-9999
Other NPIs on the same Medicare enrollment 2
Practitioners 227
-
Julie Adamek, LPCC
-
Steven Adams Jr., LSW
-
Michelle Marie Baker, LISW-S
-
Amanda Irene Balzano, LPCC-S
-
Yannette M Barnes, LPCC
-
Kimberly Bauer, LPCC
-
Kathleen C Bobulsky, LISW
-
Sharon Bollinger, LPCC
-
Stephanie Braun, LSW
-
Stacey Brind, APN
-
Belinda Rose Brown, CNP
-
Brian John Bruening, LPCC
-
Dawn C Brumfield, LISW-S
-
Jacquelyne J Bryner, LSW
-
Robin Caldwell, LISW-S
-
Alyssa Carothers, MSSA, LSW
-
Christin Lynn Carrabine, LPCC-S
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040126000762 | OH | Part B Supplier - Clinic/Group Practice | 8628970985 |
Receives reassigned benefits from 333 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ashtabula, OH; Lakewood, OH; Maple HTS, OH; Painesville, OH; Willoughby, OH |
National Provider Directory
Locations
38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | 0467 | OH | Yes |
| Clinical Medical Laboratory | 291U00000X | |||
| Physiological Laboratory | 293D00000X |
Addresses
Primary practice location
38876 Mentor Ave
Willoughby, OH 44094-7931
Mailing address
38876 Mentor Ave
Willoughby, OH 44094-7931
Phone (440) 953-9999
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2325835 | Medicaid | OH |
Other providers in Willoughby, OH
- Signature Health Inc.
- Signature Health Inc.
- Signature Health Inc.
- Signature Health Medical Group, Inc
- Signature Health, Inc
- Signature Health, Inc
- Signature Health, Inc
- Signature Health, Inc.
- Signature Health, Inc.
- Jeffrey M P Siminovitch
All providers in Willoughby, OH · Mental Health Clinic/Center (Including Community Mental Health Center) in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.