Individual provider Active NPI

Juanita McDonnell, PMHNP, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Poland, OH
National Provider Identifier
1538516000
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
19125 Issued in OH
Practice address
10154 Springfield Rd
Poland, OH 44514-3154
Phone
(308) 810-9393
NPI assigned
May 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19125-NP OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 121962 WV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024193004 VA
Family Nurse Practitioner 363LF0000X 0024193004 VA
Family Nurse Practitioner 363LF0000X 121962 WV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 19125 OH Primary

Addresses

Primary practice location

10154 Springfield Rd
Poland, OH 44514-3154

Mailing address

10154 Springfield Rd
Poland, OH 44514-3154
Phone (308) 810-9393

Other practice location 1

43676 Trade Center Pl Ste 135
Sterling, VA 20166-2124
Phone (703) 552-8960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250819003981 VA Practitioner - Nurse Practitioner 1759661887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lasting Serenity Telepsychiatry IncGroup PAC ID 3274923644, 3 clinicians

Practice addresses (Care Compare)

8665 Sudley Rd
Manassas, VA 20110-4588
Phone (571) 308-8243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19125OHMDDentist
19125-NPOHMDFamily Nurse Practitioner
121962WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lasting Serenity Telepsychiatry Inc Psychiatric/Mental Health CurrentSince Jun 1, 2025 Accepting new patients
Advanced Counseling Solutions LLC CurrentSince Sep 1, 2022 Accepting new patients
Compass Family and Community Services Past Accepting new patients
Conitaca Medical Associates,LLC Past Accepting new patients

Locations

3974 Boardman Canfield Rd
Canfield, OH 44406
Phone (330) 533-6767

8665 Sudley Rd
Manassas, VA 20110
Phone (571) 308-8243

Organizations & group practices 4

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": "1463270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1538516000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10154 SPRINGFIELD RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143154",
            "telephone_number": "308-810-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10154 SPRINGFIELD RD",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143154",
            "telephone_number": "308-810-9393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43676 Trade Center Pl Ste 135",
            "address_purpose": "LOCATION",
            "city": "Sterling",
            "state": "VA",
            "postal_code": "201662124",
            "country_code": "US",
            "telephone_number": "703-552-8960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONNELL",
        "first_name": "JUANITA",
        "credential": "PMHNP, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-15",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "19125-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WV",
            "license": "121962",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024193004",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024193004",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "121962",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "19125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

Verify at the official NPI Registry.