Active NPI
Lauren Skillicorn
- Professional Counselor
- Chardon, OH
National Provider Identifier
1578058657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C.2002501
- Practice address
- 12041 Ravenna Rd
Chardon, OH 44024-7008 - Phone
- (440) 286-7154
- NPI assigned
- Jun 29, 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 | C.2002501 | OH | Primary |
Addresses
Primary practice location
12041 Ravenna Rd
Chardon, OH 44024-7008
Mailing address
10045 Sawmill Dr
Chardon, OH 44024-9243
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.2002501 | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Well Cleveland, LLC | Professional | Current | Accepting new patients |
| Womensafe, Inc. | Past | Accepting new patients |
Locations
3000 Bridge Ave
Ste 4
Cleveland, OH 44113
Phone (216) 282-3838
1662 Mars Ave
Ste 103
Lakewood, OH 44107
Phone (440) 895-7628
1662 Mars Ave
Lakewood, OH 44107
Phone (216) 282-3838
5338 Meadow Lane Ct
Sheffield Village, OH 44035
Phone (216) 282-3838
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/womensafe/r4/
Organizations & group practices 2
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.
-
- Clinical Social Worker
- Chardon, OH
- NPI 1881661718
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585699200000",
"number": "1578058657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10045 SAWMILL DR",
"city": "CHARDON",
"state": "OH",
"postal_code": "440249243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12041 RAVENNA RD",
"city": "CHARDON",
"state": "OH",
"postal_code": "440247008",
"telephone_number": "440-286-7154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKILLICORN",
"first_name": "LAUREN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-29",
"last_updated": "2020-04-01",
"certification_date": "2020-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "C.2002501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chardon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.