Organization Active NPI

Todd J Esterburg, Lisw, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rocky River, OH
National Provider Identifier
1750878476
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
TODD J ESTERBURG, LISW, LLC
Practice address
20033 Detroit Rd Ste G
North Ridge Annex
Rocky River, OH 44116-2400
Phone
(216) 224-9230
NPI assigned
Apr 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Authorized official

Name
Mr. Todd J Esterburg, LISWNPI 1912229311
Title
Owner
Phone
(216) 224-9230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

20033 Detroit Rd Ste G
North Ridge Annex
Rocky River, OH 44116-2400

Mailing address

20033 Detroit Rd Ste G
North Ridge Annex
Rocky River, OH 44116-2400
Phone (216) 224-9230

Other identifiers 1

IdentifierTypeStateIssuer
0172967MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180504001186 OH Part B Supplier - Clinic/Group Practice 7618231317 Receives reassigned benefits from 1 practitioner
Practice locations: Rocky River, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1750878476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20033 DETROIT RD STE G",
            "address_2": "NORTH RIDGE ANNEX",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441162400",
            "telephone_number": "216-224-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20033 DETROIT RD STE G",
            "address_2": "NORTH RIDGE ANNEX",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441162400",
            "telephone_number": "216-224-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TODD J ESTERBURG, LISW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A",
        "authorized_official_last_name": "ESTERBURG",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-224-9230",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0172967",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.