NPIMap

Organization Active NPI

Signature Health, Inc.

  • Mental Health Counselor
  • Garfield Heights, OH
National Provider Identifier
1679767289
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
467 Issued in OH
Legal business name
SIGNATURE HEALTH, INC.
Practice address
5410 Transportation Blvd
Unit 4
Garfield Heights, OH 44125-5380
Phone
(216) 663-6100
Fax
(216) 663-7113
NPI assigned
Aug 28, 2007
Last updated
Oct 1, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

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

Authorized official

Name
Jonathan Albert Lee
Title
Ceo
Phone
(440) 953-9999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 467 OH Primary

Addresses

Primary practice location

5410 Transportation Blvd
Unit 4
Garfield Heights, OH 44125-5380

Mailing address

38879 Mentor Ave
Suite C
Willoughby, OH 44094-7992
Phone (440) 953-9999

Other names 1

  • North Coast Student Assistance, Corp. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000762 OH Part B Supplier - Clinic/Group Practice 8628970985 Receives reassigned benefits from 333 practitioners
2 other NPIs on this enrollment
Practice locations: Ashtabula, OH; Lakewood, OH; Maple HTS, OH; Painesville, OH; Willoughby, OH

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

Practitioners & affiliated clinicians

Practitioners 340

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 340

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1679767289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38879 MENTOR AVE",
            "address_2": "SUITE C",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947992",
            "telephone_number": "440-953-9999",
            "fax_number": "440-918-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 TRANSPORTATION BLVD",
            "address_2": "UNIT 4",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441255380",
            "telephone_number": "216-663-6100",
            "fax_number": "216-663-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "440-953-9999"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Coast Student Assistance, Corp.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Garfield Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.