Individual provider Active NPI

Emily Kay Malmstrom

  • Addiction (Substance Use Disorder) Counselor
  • Cleveland, OH
National Provider Identifier
1609584812
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
182496 Issued in OH
Practice address
2020 Carnegie Ave
Cleveland, OH 44115-2337
Phone
(216) 859-9500
Fax
(216) 415-5635
NPI assigned
Nov 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X 182496 OH Primary

Addresses

Primary practice location

2020 Carnegie Ave
Cleveland, OH 44115-2337

Mailing address

2020 Carnegie Ave
Cleveland, OH 44115-2337
Phone (216) 859-9500

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

State licenses

LicenseStateTypeSpecialty
182496OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone Past Accepting new patients

Organizations & group practices 1

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": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1609584812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 CARNEGIE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152337",
            "telephone_number": "216-859-9500",
            "fax_number": "216-415-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 CARNEGIE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152337",
            "telephone_number": "216-859-9500",
            "fax_number": "216-415-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALMSTROM",
        "first_name": "EMILY",
        "middle_name": "KAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "182496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.