Individual provider Active NPI

Carl Ryan Brass, PCC

  • Mental Health Counselor
  • Shaker Heights, OH
National Provider Identifier
1619270402
Registry record updated Dec 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E 1000014 Issued in OH
Practice address
22001 Fairmount Blvd
Shaker Heights, OH 44118-4819
Phone
(216) 320-8581
NPI assigned
Dec 16, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2010

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 E 1000014 OH Primary

Addresses

Primary practice location

22001 Fairmount Blvd
Shaker Heights, OH 44118-4819

Mailing address

1415 W Miner Rd
Mayfield HTS, OH 44124-1773
Phone (216) 773-0742

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
E 1000014OHMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1619270402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 W MINER RD",
            "city": "MAYFIELD HTS",
            "state": "OH",
            "postal_code": "441241773",
            "telephone_number": "216-773-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-320-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASS",
        "first_name": "CARL",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "PCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-16",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E 1000014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; 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.