Individual provider Active NPI

Justin O Simons, PCC

  • Professional Counselor
  • Willoughby Hills, OH
National Provider Identifier
1811156573
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E 0500992 Issued in OH
Practice address
35000 Chardon Rd
# 210
Willoughby Hills, OH 44094-9012
Phone
(440) 951-5600
NPI assigned
Jun 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E 0500992 OH Primary

Addresses

Primary practice location

35000 Chardon Rd
# 210
Willoughby Hills, OH 44094-9012

Mailing address

135 Burlington Oval Dr
Chardon, OH 44024-1453
Phone (440) 636-3914

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
I20231223000288 OH Practitioner - Mental Health Counselor 6800246372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Layh and Associates IncGroup PAC ID 0749266591, 15 clinicians

Practice addresses (Care Compare)

416 Xenia Ave
Yellow Springs, OH 45387-1836
Phone (937) 767-9171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E 0500992OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Layh & Associates Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

416 Xenia Ave
Yellow Springs, OH 45387
Phone (937) 767-9171

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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1811156573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 BURLINGTON OVAL DR",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440241453",
            "telephone_number": "440-636-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35000 CHARDON RD",
            "address_2": "# 210",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949012",
            "telephone_number": "440-951-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "JUSTIN",
        "middle_name": "O",
        "credential": "PCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E 0500992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby Hills, OH

Sources for this page

Verify at the official NPI Registry.