Serita J Eiland, LPC-MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.2002954 Issued in OH

Practice address

9205 State Route 43 Ste 210
Streetsboro, OH 44241-5367

Phone

(330) 968-5976

NPI assigned

Oct 19, 2018

Last updated

Jul 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 2Inspire Balance

  • Mental Health Counselor
  • Streetsboro, OH
  • NPI 1285207704
  NPD Authorized official

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1508332206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9453 VISTA CT",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442413601",
            "telephone_number": "330-541-3207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 STATE ROUTE 43 STE 210",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442415367",
            "telephone_number": "330-968-5976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3094 W Market St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fairlawn",
            "state": "OH",
            "postal_code": "443333617",
            "country_code": "US",
            "telephone_number": "440-260-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EILAND",
        "first_name": "SERITA",
        "middle_name": "J",
        "credential": "LPC-MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2002954",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2002954",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "C.1801334-TRNE",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0320375",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Streetsboro, OH
• Providers in Streetsboro, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.