Individual provider Active NPI

Linda Tackla, PC

  • Professional Counselor
  • Parma, OH
National Provider Identifier
1679820641
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C.0501204 Issued in OH
Practice address
6753 State Rd
Parma, OH 44134-4517
Phone
(216) 319-0626
Fax
(440) 843-1626
NPI assigned
Aug 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C.0501204 OH
Mental Health Counselor 101YM0800X C.0501204 OH
Professional Counselor 101YP2500X C.0501204 OH Primary
School Counselor 101YS0200X C.0501204 OH
Behavior Analyst 103K00000X C.0501204 OH

Addresses

Primary practice location

6753 State Rd
Parma, OH 44134-4517

Mailing address

6753 State Rd
Parma, OH 44134-4517
Phone (216) 319-0626

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
C.0501204OHMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1679820641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6753 STATE RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441344517",
            "telephone_number": "216-319-0626",
            "fax_number": "440-843-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6753 STATE RD",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441344517",
            "telephone_number": "216-319-0626",
            "fax_number": "440-843-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKLA",
        "first_name": "LINDA",
        "credential": "PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.0501204",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.0501204",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.0501204",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "OH",
            "license": "C.0501204",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OH",
            "license": "C.0501204",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parma, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.