Individual provider Active NPI

Ryan Fernandez

  • Professional Counselor
  • Euclid, OH
National Provider Identifier
1811468655
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2303433 Issued in OH
Practice address
22639 Euclid Ave
Euclid, OH 44117-1622
Phone
(216) 404-1900
NPI assigned
Dec 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Professional Counselor 101YP2500X E.2303433 OH Primary

Addresses

Primary practice location

22639 Euclid Ave
Euclid, OH 44117-1622

Mailing address

2222 Detroit Ave Apt 1002
Cleveland, OH 44113-2461

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
I20240111002842 OH Practitioner - Mental Health Counselor 5092166223 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

2800 Euclid Ave
Ste 500
Cleveland, OH 44115

1890 Northwest Blvd
Ste 140
Columbus, OH 43212
Phone (614) 515-6291

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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": "1543968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1811468655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 DETROIT AVE APT 1002",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441132461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22639 EUCLID AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171622",
            "telephone_number": "216-404-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-05",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2303433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euclid, OH

Sources for this page

Verify at the official NPI Registry.