Individual provider Active NPI

Elizabeth Ann Gulliford, PEER SPECIALIST

  • Peer Specialist
  • Lakewood, OH
National Provider Identifier
1699367045
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
0002212 Issued in OH
Practice address
14918 Delaware Ave
Lakewood, OH 44107-5521
Phone
(216) 644-6907
NPI assigned
Feb 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 0002212 OH Primary

Addresses

Primary practice location

14918 Delaware Ave
Lakewood, OH 44107-5521

Mailing address

14918 Delaware Ave
Lakewood, OH 44107-5521
Phone (216) 644-6907

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
0002212OHMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1699367045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14918 DELAWARE AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441075521",
            "telephone_number": "216-644-6907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14918 DELAWARE AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441075521",
            "telephone_number": "216-644-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLIFORD",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "PEER SPECIALIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "0002212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.