Active NPI
Angela Isom, COUNSELING LICENSE
- Mental Health Counselor
- Cleveland Heights, OH
National Provider Identifier
1700320884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C.1200588
- Practice address
- 2000 Lee Rd
Cleveland Heights, OH 44118-2572 - Phone
- (216) 592-8521
- NPI assigned
- Dec 8, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C.1200588 | OH | Primary |
Addresses
Primary practice location
2000 Lee Rd
Cleveland Heights, OH 44118-2572
Mailing address
17419 Wayne Dr
Cleveland, OH 44128-3372
Phone (216) 592-8521
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
| License | State | Type | Specialty |
|---|---|---|---|
| C.1200588 | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Johnson Center | Mental Health | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481155200000",
"number": "1700320884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17419 WAYNE DR",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441283372",
"telephone_number": "216-592-8521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 LEE RD",
"city": "CLEVELAND HEIGHTS",
"state": "OH",
"postal_code": "441182572",
"telephone_number": "216-592-8521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISOM",
"first_name": "ANGELA",
"name_prefix": "Prof.",
"credential": "COUNSELING LICENSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-12-08",
"last_updated": "2016-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "C.1200588",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.