NPIMap

Organization Active NPI

Cleveland Therapy Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Westlake, OH
National Provider Identifier
1770109035
Registry record updated Jun 23, 2020
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
CLEVELAND THERAPY GROUP
Practice address
24500 Center Ridge Rd Ste 395
Westlake, OH 44145-5631
Phone
(419) 357-4960
NPI assigned
Jun 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Authorized official

Name
Nichole Jean Wilson, LISWNPI 1225418114
Title
Partner
Phone
(419) 357-4960

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

24500 Center Ridge Rd Ste 395
Westlake, OH 44145-5631

Mailing address

24500 Center Ridge Rd Ste 395
Westlake, OH 44145-5631
Phone (419) 357-4960

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241002000773 OH Part B Supplier - Clinic/Group Practice 6002347044 Receives reassigned benefits from 6 practitioners
Practice locations: Westlake, OH

National Provider Directory

National Provider Directory

Locations

24500 Center Ridge Rd
Ste 395
Westlake, OH 44145
Phone (440) 455-9125

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1770109035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24500 CENTER RIDGE RD STE 395",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455631",
            "telephone_number": "419-357-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24500 CENTER RIDGE RD STE 395",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455631",
            "telephone_number": "419-357-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND THERAPY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "419-357-4960",
        "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.