Individual provider Active NPI

Heidi Eversole, MA, LPC, TF-CBT

  • Mental Health Counselor
  • West Chester, OH
National Provider Identifier
1871006304
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.1801364 Issued in OH
Practice address
9078 Union Centre Blvd Ste 350
West Chester, OH 45069-4992
Phone
(513) 613-4726
Fax
(513) 964-9029
NPI assigned
Nov 7, 2017
Last updated
Nov 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.1801364 OH Primary

Addresses

Primary practice location

9078 Union Centre Blvd Ste 350
West Chester, OH 45069-4992

Mailing address

9078 Union Centre Blvd Ste 350
West Chester, OH 45069-4992
Phone (513) 613-4726

Other identifiers 5

IdentifierTypeStateIssuer
0074946OtherOHODMH
0074861OtherOHODADAS
01-0693OtherOHCARF
C.1801364OtherOHOHIO SOCIAL WORKER, COUNSELOR AND MARRIAGE AND FAMILY COUNSELING BOARD
H130910OtherOHPTAN GROUP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address heversole@pathtomending.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
C.1801364OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Path to Mending, LLC Current Accepting new patients
Access Counseling Services LLC Mental Health PastSince Nov 4, 2014 Accepting new patients
Access Counseling Services, LLC Past Accepting new patients

Locations

9078 Union Centre Blvd
Ste 350
West Chester, OH 45069
Phone (513) 440-7407

Organizations & group practices 3

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": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1871006304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9078 UNION CENTRE BLVD STE 350",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450694992",
            "telephone_number": "513-613-4726",
            "fax_number": "513-964-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9078 UNION CENTRE BLVD STE 350",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450694992",
            "telephone_number": "513-613-4726",
            "fax_number": "513-964-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERSOLE",
        "first_name": "HEIDI",
        "credential": "MA, LPC, TF-CBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1801364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODMH",
            "identifier": "0074946",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODADAS",
            "identifier": "0074861",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARF",
            "identifier": "01-0693",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO SOCIAL WORKER, COUNSELOR AND MARRIAGE AND FAMILY COUNSELING BOARD",
            "identifier": "C.1801364",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN GROUP",
            "identifier": "H130910",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "heversole@pathtomending.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "9078 Union Centre Blvd Ste 350",
            "city": "West Chester",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450694992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.