NPIMap

Organization Active NPI

The Black Mental Health Corporation

  • Addiction (Substance Use Disorder) Counselor
  • Cleveland, OH
National Provider Identifier
1679140040
Registry record updated Jun 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
THE BLACK MENTAL HEALTH CORPORATION
Practice address
13110 Shaker SQ Ste C200
Cleveland, OH 44120-2373
Phone
(216) 512-0321
Fax
(216) 370-3192
NPI assigned
Jun 5, 2021
Last updated
Jun 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2021

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

Authorized official

Name
Mr. Desmond Eugene Yanamayu, LISW-SNPI 1437403698
Title
Clinical Director
Phone
(330) 518-4863

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

13110 Shaker SQ Ste C200
Cleveland, OH 44120-2373

Mailing address

4531 Emerson Rd
South Euclid, OH 44121-3929
Phone (330) 518-4863

Other identifiers 1

IdentifierTypeStateIssuer
0443172MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
The Black Mental Health Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1622851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622851200000",
    "number": "1679140040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 EMERSON RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441213929",
            "telephone_number": "330-518-4863",
            "fax_number": "216-370-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13110 SHAKER SQ STE C200",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202373",
            "telephone_number": "216-512-0321",
            "fax_number": "216-370-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BLACK MENTAL HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-05",
        "last_updated": "2021-06-05",
        "certification_date": "2021-06-05",
        "status": "A",
        "authorized_official_last_name": "YANAMAYU",
        "authorized_official_first_name": "DESMOND",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "330-518-4863",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0443172",
            "state": "OH"
        }
    ],
    "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 Jun 5, 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.