Kristie M. Persson, LPCC-SUPV

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E0900061-SUPV Issued in OH

Practice address

4400 Euclid Ave
Cleveland, OH 44103-3734

Phone

(216) 432-7200

Fax

(216) 432-7253

NPI assigned

Mar 16, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Circle Health Services

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1386609857
  Medicare reassignment NPD
• Circle Health Services

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1396552949
  NPD
• Circle Health Services

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1225545312
  NPD (past)
• Circle Health Services

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1568978948
  NPD (past)

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1477914547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441033736",
            "telephone_number": "216-432-7200",
            "fax_number": "216-432-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441033734",
            "telephone_number": "216-432-7200",
            "fax_number": "216-432-7253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSSON",
        "first_name": "KRISTIE",
        "middle_name": "M.",
        "credential": "LPCC-SUPV",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0900061-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "E 0900061-SUPV",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ian Persits, DO
• James Michael Persky, M.D.
• Personal Guardian Home Care LLC
• Personal Leasing Transportation Co.
• Marjie L Persons, MD
• Muhammed Nabil Pervaiz, CPSA
• Stanka Pervitic
• Gerhard Louis Perz, M.D.
• Holly B Perzy, MD, MMM
• Kylee Pesa, PA-C

• Professional Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.