Shiyue Qin, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2102709 Issued in OH

Practice address

2460 Fairmount Blvd Ste 209
Cleveland Heights, OH 44106-3125

Phone

(216) 777-9587

NPI assigned

Aug 6, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mind Trek Counseling LLCGroup PAC ID 8123556685, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mind Trek Counseling LLC

  • Clinical Social Worker
  • Cleveland Heights, OH
  • NPI 1467035097

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1871071415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 FAIRMOUNT BLVD STE 209",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441063125",
            "telephone_number": "216-777-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 FAIRMOUNT BLVD STE 209",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441063125",
            "telephone_number": "216-777-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIN",
        "first_name": "SHIYUE",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-06",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2102709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl C Pritchard
• Traci M Pruitt
• Theresa Puckett, RN
• Shiovhan Pullom
• Vineet Punia, MD
• Quality Life Care Solutions, LLC
• R.Z. Rich and Associaties Inc.
• Richa Raina
• Kenneth Rainey II
• Susan Rakow, PC

• Clinical Social Worker in Cleveland Heights, OH
• Providers in Cleveland Heights, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.