Rebecca Nicely, MFT

Primary specialty

CounselorTaxonomy code 101Y00000X

License

E1800547 Issued in OH

Practice address

12557 Ravenwood Dr
Chardon, OH 44024

Phone

(440) 283-5681

NPI assigned

Jan 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ravenwood Mental Health CenterGroup PAC ID 6901813922, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Ravenwood Mental Health Center

  • Community/Behavioral Health Agency
  • Chardon, OH
  • NPI 1730356296
  Medicare reassignment Care Compare group NPD
• Ravenwood Mental Health Center

  • Addiction (Substance Use Disorder) Counselor
  • Chardon, OH
  • NPI 1912265794
  NPD
• Ravenwood Mental Health Center

  • General Practice Physician
  • Chardon, OH
  • NPI 1932666740
  NPD

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1568829075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 CINWOOD ST NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446465113",
            "telephone_number": "330-949-9859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12557 RAVENWOOD DR",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "44024",
            "telephone_number": "440-283-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICELY",
        "first_name": "REBECCA",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-28",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OH",
            "license": "1600006",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E1800547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Nicole Nelson, COSMETIC THERAPIST
• Natalie M Nelson
• Michael Nerone
• Oscar Neuhaus
• Melissa N Newport, LSW
• Brenda Nichols-Omiecinski, CRNA
• Melissa Nielsen, MD
• Elizabeth Christine Nitz, SWT
• Carol L Noall, MD
• Kala Maria Noce, LISW

• Counselor in Chardon, OH
• Providers in Chardon, OH by specialty
• Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.