Individual provider Active NPI

Cynthia M Simo, PCC-S

  • Professional Counselor
  • Lorain, OH
National Provider Identifier
1720352669
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0602042-SUPV Issued in OH
Practice address
2173 N Ridge Rd E
Lorain, OH 44055-3400
Phone
(440) 260-6108
Fax
(440) 282-3400
NPI assigned
Feb 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C.0602042 OH
Professional Counselor 101YP2500X E.0602042-SUPV OH Primary

Addresses

Primary practice location

2173 N Ridge Rd E
Lorain, OH 44055-3400

Mailing address

2173 N Ridge Rd E
Lorain, OH 44055-3400
Phone (440) 260-6108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240529002865 OH Practitioner - Mental Health Counselor 8325480882 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.0602042OHMDProfessional Counselor
E.0602042-SUPVOHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone Current Accepting new patients
Ohioguidestone CurrentSince Mar 30, 2024 Accepting new patients
Ohioguidestone CurrentSince Mar 30, 2024 Accepting new patients

Locations

434 Eastland Rd
Berea, OH 44017
Phone (440) 260-8327

202 E Bagley Rd
Berea, OH 44017
Phone (440) 260-8327

2173 N Ridge Rd E
Ste E
Lorain, OH 44055
Phone (440) 260-6100

2173 N Ridge Rd E
#G
Lorain, OH 44055

Organizations & group practices 3

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": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1720352669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2173 N RIDGE RD E",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440553400",
            "telephone_number": "440-260-6108",
            "fax_number": "440-282-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2173 N RIDGE RD E",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440553400",
            "telephone_number": "440-260-6108",
            "fax_number": "440-282-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMO",
        "first_name": "CYNTHIA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PCC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-23",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.0602042",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0602042-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.