Active NPI
Jybrell Isaiah Boyd, QMHS
- Mental Health Counselor
- Berea, OH
National Provider Identifier
1578239596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 398 W Bagley Rd Ste 216
Berea, OH 44017-1312 - Phone
- (216) 340-0011
- Fax
- (440) 815-2332
- NPI assigned
- Aug 19, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
398 W Bagley Rd Ste 216
Berea, OH 44017-1312
Mailing address
398 W Bagley Rd Ste 216
Berea, OH 44017-1312
Phone (216) 340-0011
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ace Wellness Center | Mental Health | Current | Accepting new patients |
| Ace Wellness Center | Mental Health | Current | Accepting new patients |
Locations
398 W Bagley Rd
Ste 216
Berea, OH 44017
Phone (216) 340-0011
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.
-
- Mental Health Counselor
- Berea, OH
- NPI 1205393949
-
- Mental Health Counselor
- Berea, OH
- NPI 1710506118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629331200000",
"number": "1578239596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "398 W BAGLEY RD STE 216",
"city": "BEREA",
"state": "OH",
"postal_code": "440171312",
"telephone_number": "216-340-0011",
"fax_number": "440-815-2332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "398 W BAGLEY RD STE 216",
"city": "BEREA",
"state": "OH",
"postal_code": "440171312",
"telephone_number": "216-340-0011",
"fax_number": "440-815-2332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "JYBRELL",
"middle_name": "ISAIAH",
"name_prefix": "Mr.",
"credential": "QMHS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-19",
"last_updated": "2021-08-19",
"certification_date": "2021-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Berea, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.