Individual provider Active NPI

Tiffany Leonatti

  • Professional Counselor
  • Chardon, OH
National Provider Identifier
1609438605
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C.1901799 Issued in OH
Practice address
695 South St
Chardon, OH 44024-1474
Phone
(440) 286-1631
Fax
(440) 286-1634
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C.1901799 OH Primary

Addresses

Primary practice location

695 South St
Chardon, OH 44024-1474

Mailing address

15136 Timber Ridge Dr
Middlefield, OH 44062-9031
Phone (440) 537-0162

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240208000310 OH Practitioner - Mental Health Counselor 5597108423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ravenwood Mental Health CenterGroup PAC ID 6901813922, 57 clinicians

Practice addresses (Care Compare)

12557 Ravenwood Dr
Chardon, OH 44024-9009
Phone (440) 285-3568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1901799OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ravenwood Mental Health Center CurrentSince Dec 25, 2023 Accepting new patients
Ravenwood Mental Health Center CurrentSince Dec 25, 2023 Accepting new patients
Ravenwood Mental Health Center Current Accepting new patients

Locations

695 South St
Chardon, OH 44024
Phone (440) 286-1553

12557 Ravenwood Dr
Concord Twp, OH 44024
Phone (440) 990-6104

Organizations & group practices 3

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": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1609438605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15136 TIMBER RIDGE DR",
            "city": "MIDDLEFIELD",
            "state": "OH",
            "postal_code": "440629031",
            "telephone_number": "440-537-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 SOUTH ST",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241474",
            "telephone_number": "440-286-1631",
            "fax_number": "440-286-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONATTI",
        "first_name": "TIFFANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1901799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

Verify at the official NPI Registry.