Individual provider Active NPI

Paula Srebala, LSW

  • Addiction (Substance Use Disorder) Counselor
  • Elyria, OH
National Provider Identifier
1639580384
Registry record updated May 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
S0031706 Issued in OH
Practice address
750 Abbe Rd S
Elyria, OH 44035-7246
Phone
(440) 323-5121
Fax
(440) 323-5134
NPI assigned
May 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X S0031706 OH Primary
Mental Health Counselor 101YM0800X S0031706 OH

Addresses

Primary practice location

750 Abbe Rd S
Elyria, OH 44035-7246

Mailing address

750 Abbe Rd S
Elyria, OH 44035-7246
Phone (440) 323-5121

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
S0031706OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400112000000",
    "number": "1639580384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 ABBE RD S",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440357246",
            "telephone_number": "440-323-5121",
            "fax_number": "440-323-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 ABBE RD S",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440357246",
            "telephone_number": "440-323-5121",
            "fax_number": "440-323-5134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SREBALA",
        "first_name": "PAULA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-15",
        "last_updated": "2014-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "S0031706",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "S0031706",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; 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.