Active NPI
Terry Maynard
- Addiction (Substance Use Disorder) Counselor
- Euclid, OH
National Provider Identifier
1881103364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.120822
- Practice address
- 27801 Euclid Ave Ste 610
Euclid, OH 44132-3575 - Phone
- (216) 731-1967
- Fax
- (216) 289-1978
- NPI assigned
- Sep 27, 2017
- Reactivated
- Jun 22, 2022
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.120822 | OH | Primary |
Addresses
Primary practice location
27801 Euclid Ave Ste 610
Euclid, OH 44132-3575
Mailing address
27801 Euclid Ave Ste 610
Euclid, OH 44132-3575
Phone (216) 731-1967
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.120822 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Circle of Care Ohio, LLC | Addiction (Substance Use Disorder) | Current | Accepting new patients |
| Careersource Management | Current | Accepting new patients | |
| Omni Park Health Care, LLC | Current | Accepting new patients |
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.
-
dba Circle of Care
- Addiction (Substance Use Disorder) Counselor
- Euclid, OH
- NPI 1316457492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1881103364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27801 EUCLID AVE STE 610",
"city": "EUCLID",
"state": "OH",
"postal_code": "441323575",
"telephone_number": "216-731-1967",
"fax_number": "216-289-1978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27801 EUCLID AVE STE 610",
"city": "EUCLID",
"state": "OH",
"postal_code": "441323575",
"telephone_number": "216-731-1967",
"fax_number": "216-289-1978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYNARD",
"first_name": "TERRY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-27",
"last_updated": "2022-07-21",
"certification_date": "2022-06-22",
"deactivation_date": "2017-10-03",
"reactivation_date": "2022-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.120822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Euclid, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.