Individual provider Active NPI

Jybrell Isaiah Boyd, QMHS

  • Mental Health Counselor
  • Berea, OH
National Provider Identifier
1578239596
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
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

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

OrganizationSpecialtyStatusNew patients
Ace Wellness Center Mental Health CurrentSince Aug 1, 2023 Accepting new patients
Ace Wellness Center Mental Health CurrentSince Aug 28, 2021 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.

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.

Verify at the official NPI Registry.