Individual provider Active NPI

Carrie M Callahan, CT, MFTT

  • Mental Health Counselor
  • Cleveland, OH
National Provider Identifier
1760973622
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.1700676-TRNE Issued in OH
Practice address
3500 Carnegie Ave
Cleveland, OH 44115-2641
Phone
(216) 630-2814
NPI assigned
May 25, 2018
Last updated
May 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.1700676-TRNE OH Primary
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

3500 Carnegie Ave
Cleveland, OH 44115-2641

Mailing address

3500 Carnegie Ave
Cleveland, OH 44115-2641
Phone (216) 630-2814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: No
  • 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
I20240304002354 OH Practitioner - Mental Health Counselor 1951746692 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1700676-TRNEOHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Transformation Wellness LLC Mental Health CurrentSince Feb 1, 2024 Accepting new patients

Locations

17951 Jefferson Park Rd
Ste 100
Middleburg Heights, OH 44130
Phone (440) 879-8517

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1760973622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 CARNEGIE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152641",
            "telephone_number": "216-630-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 CARNEGIE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152641",
            "telephone_number": "216-630-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "CARRIE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "CT, MFTT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1700676-TRNE",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.