Active NPI
Kathleen Eustace, LPC
- Professional Counselor
- Cleveland, OH
National Provider Identifier
1548753734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C1800916
- Practice address
- 11401 Lorain Ave
Cleveland, OH 44111 - Phone
- (216) 416-4277
- NPI assigned
- Jun 12, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C1800916 | OH | Primary |
Addresses
Primary practice location
11401 Lorain Ave
Cleveland, OH 44111
Mailing address
11401 Lorain Ave
Cleveland, OH 44111-5428
Other practice location 1
3500 Carnegie Ave
Cleveland, OH 44115-2641
Phone (440) 260-8300
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
| License | State | Type | Specialty |
|---|---|---|---|
| C1800916 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532390400000",
"number": "1548753734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11401 LORAIN AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441115428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11401 LORAIN AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "44111",
"telephone_number": "216-416-4277"
}
],
"practiceLocations": [
{
"address_1": "3500 Carnegie Ave",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "441152641",
"country_code": "US",
"telephone_number": "440-260-8300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EUSTACE",
"first_name": "KATHLEEN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-12",
"last_updated": "2018-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "C1800916",
"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 Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.