Jennifer Rae Mlady, CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

022585 Issued in OH

Practice address

3929 Rocky River Dr
Cleveland, OH 44111-4153

Phone

(216) 252-9055

NPI assigned

Apr 20, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Arts, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.jennifermlady@140094.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psychological & Behavioral Consultants, LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Circle Health Services

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1386609857

  Multi-Specialty

  Medicare reassignment NPD
• Circle Health Services

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1396552949
  NPD
• Circle Health Services

  • Federally Qualified Health Center (FQHC)
  • Cleveland, OH
  • NPI 1568978948
  NPD (past)

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1689161002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 ROCKY RIVER DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441114153",
            "telephone_number": "216-252-9055",
            "fax_number": "216-362-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 ROCKY RIVER DR",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441114153",
            "telephone_number": "216-252-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLADY",
        "first_name": "JENNIFER",
        "middle_name": "RAE",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "022585",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "022585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gdalyho Mizel, RN
• Adam Mizer, DPT
• MJJD Spine Group, LTD
• Samar Mkhayel, MD
• Mkmi Cleveland, LLC
• Brittany Danielle Mlazovsky, CNP
• Matthew Mlckovsky, LPN
• MLW Counseling LLC
• MM Dumpsters LLC
• MM Dumpsters, LLC

• Psychiatric/Mental Health Nurse Practitioner in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Psychiatric/Mental Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.