Individual provider Active NPI

Renee Barker

  • Professional Counselor
  • Cleveland, OH
National Provider Identifier
1487059572
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C.1300684 Issued in OH
Practice address
11801 Buckeye Rd
Cleveland, OH 44120-2620
Phone
(216) 831-2255
NPI assigned
Oct 31, 2014
Last updated
Oct 31, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C.1300684 OH Primary

Addresses

Primary practice location

11801 Buckeye Rd
Cleveland, OH 44120-2620

Mailing address

3737 Lander Rd
Cleveland, OH 44124-5712
Phone (216) 831-2255

Other identifiers 1

IdentifierTypeStateIssuer
2871101MedicaidOH

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
I20260112003194 OH Practitioner - Mental Health Counselor 3173009818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4680 Douglas Cir NW
Canton, OH 44718-3619
Phone (330) 703-6578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1300684OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elyse Etapa LLC CurrentSince Dec 1, 2025 Accepting new patients
Beech Brook Past Accepting new patients

Locations

4680 Douglas Cir NW
Canton, OH 44718
Phone (330) 445-7889

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1487059572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 LANDER RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441245712",
            "telephone_number": "216-831-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 BUCKEYE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202620",
            "telephone_number": "216-831-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKER",
        "first_name": "RENEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1300684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2871101",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.