NPIMap

Organization Active NPI

Exodus Counseling Services LLC

  • Addiction (Substance Use Disorder) Counselor
  • Willoughby, OH
National Provider Identifier
1689074023
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
081194 Issued in OH
Legal business name
EXODUS COUNSELING SERVICES LLC
Doing business as
Exodus Clinical Counseling Services
Practice address
30841 Euclid Ave
Suite 201
Willoughby, OH 44094-3100
Phone
(440) 516-0281
NPI assigned
Sep 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Authorized official

Name
Ms. Karen Larkins Graves, LPCC, LCDCIIINPI 1386961910
Title
Exec Clinical Counselor
Phone
(440) 516-0281

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) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X 081194 OH Primary

Addresses

Primary practice location

30841 Euclid Ave
Suite 201
Willoughby, OH 44094-3100

Mailing address

30841 Euclid Ave
Suite 201
Willoughby, OH 44094-3100
Phone (440) 516-0281

Other identifiers 1

IdentifierTypeStateIssuer
1386961910OtherOHNPI

Other names 1

  • Exodus Clinical Counseling Services Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2317873Exodus Counseling Services30841 Euclid Avenue, Suite 201/202, Willoughby, OH 44094Certificate of waiverFeb 2, 2027

National Provider Directory

National Provider Directory

Locations

30841 Euclid Ave
Ste 201
Willoughby, OH 44094
Phone (440) 249-7695

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1689074023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30841 EUCLID AVE",
            "address_2": "SUITE 201",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440943100",
            "telephone_number": "440-516-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30841 EUCLID AVE",
            "address_2": "SUITE 201",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440943100",
            "telephone_number": "440-516-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXODUS COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "LARKINS",
        "authorized_official_title_or_position": "EXEC CLINICAL COUNSELOR",
        "authorized_official_telephone_number": "440-516-0281",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPCC, LCDCIII"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "081194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1386961910",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Exodus Clinical Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.