Individual provider Active NPI

James Minnieweather Sr., LICDC-CS

  • Addiction (Substance Use Disorder) Counselor
  • Cleveland, OH
National Provider Identifier
1538604905
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
975884 Issued in OH
Practice address
15362 Yorick Ave
Cleveland, OH 44110-3224
Phone
(216) 978-8500
Fax
(216) 420-7744
NPI assigned
Dec 21, 2016
Last updated
Dec 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 975884 OH Primary

Addresses

Primary practice location

15362 Yorick Ave
Cleveland, OH 44110-3224

Mailing address

11100 Saint Clair Ave
Cleveland, OH 44108-1943
Phone (216) 664-3891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
975884OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1538604905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 SAINT CLAIR AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441081943",
            "telephone_number": "216-664-3891",
            "fax_number": "216-420-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15362 YORICK AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441103224",
            "telephone_number": "216-978-8500",
            "fax_number": "216-420-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNIEWEATHER",
        "first_name": "JAMES",
        "name_suffix": "Sr.",
        "credential": "LICDC-CS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "975884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.