Individual provider Active NPI

Gina M Laterza, PCC

  • Professional Counselor
  • Akron, OH
National Provider Identifier
1508040742
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0007871 Issued in OH
Practice address
520 S Main St Ste 2511-22
Akron, OH 44311-1072
Phone
(330) 687-4439
Fax
(330) 319-6592
NPI assigned
Dec 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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 E.0007871 OH Primary

Addresses

Primary practice location

520 S Main St Ste 2511-22
Akron, OH 44311-1072

Mailing address

520 S Main St Ste 2511-22
Akron, OH 44311-1072
Phone (330) 687-4439

Other practice location 1

750 E Washington St
Medina, OH 44256-2196
Phone (330) 361-9143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2024 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.0007871OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Your Story Counseling Services, LLC Professional CurrentSince Jul 25, 2019 Accepting new patients

Locations

520 S Main St
Ste 251122
Akron, OH 44311
Phone (330) 687-4439

Organizations & group practices 1

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": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1508040742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S MAIN ST STE 2511-22",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443111072",
            "telephone_number": "330-687-4439",
            "fax_number": "330-319-6592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S MAIN ST STE 2511-22",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443111072",
            "telephone_number": "330-687-4439",
            "fax_number": "330-319-6592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Washington St",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442562196",
            "country_code": "US",
            "telephone_number": "330-361-9143",
            "fax_number": "330-361-9143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATERZA",
        "first_name": "GINA",
        "middle_name": "M",
        "credential": "PCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0007871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.