Desiree Summers, LPCC-S

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.0900411-SUPV Issued in OH

Practice address

1075 S Court St Ste 500
Medina, OH 44256-4354

Phone

(216) 396-0629

Fax

(330) 319-6111

NPI assigned

Jan 19, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Lighthouse Family Guidance

  • Mental Health Counselor
  • Medina, OH
  • NPI 1750778411
  NPD Authorized official

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1871824649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 S COURT ST STE 500",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442564354",
            "telephone_number": "216-396-0629",
            "fax_number": "330-319-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 S COURT ST STE 500",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442564354",
            "telephone_number": "216-396-0629",
            "fax_number": "330-319-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "DESIREE",
        "name_prefix": "Ms.",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0900411-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPCC-S",
            "identifier": "E.0900411-SUPV",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0253004",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summa Physicians LLC (Summa Health Medical Group)
• Summa Physicians LLC (Summa Health Medical Group)
• Summa Physicians LLC (Summa Health Medical Group)
• Summa Physicians LLC (Summa Health Medical Group)
• Summa Physicians LLC (Summa Health Medical Group)
• Summerville at Camelot Place LLC (Emeritus at Camelot Place)
• Jennifer Sunday, L.P.C.C.
• Denise Sundby
• Casey Surblis, M. ED., BCBA
• Surgical Associates of Medina

• Mental Health Counselor in Medina, OH
• Providers in Medina, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.