Individual provider Active NPI

Stephanie Seldon

  • Mental Health Counselor
  • Fairview Park, OH
National Provider Identifier
1720717473
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.2204004-TRNE Issued in OH
Practice address
21430 Lorain Rd Ste 400
Fairview Park, OH 44126-2148
Phone
(330) 529-5667
NPI assigned
Jun 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.2204004-TRNE OH Primary

Addresses

Primary practice location

21430 Lorain Rd Ste 400
Fairview Park, OH 44126-2148

Mailing address

3628 Ingleside Rd
Shaker Heights, OH 44122-5093

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
C.2204004-TRNEOHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Colors Plus Counseling Mental Health PastSince Jun 12, 2022 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": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1720717473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3628 INGLESIDE RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441225093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21430 LORAIN RD STE 400",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262148",
            "telephone_number": "330-529-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELDON",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2204004-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Park, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.