Individual provider Active NPI

Andrea Lyn O'Brien, LPCC

  • Professional Counselor
  • Cleveland, OH
National Provider Identifier
1891065405
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E-1954 Issued in OH
Practice address
3500 Carnegie Ave
Cleveland, OH 44115-2641
Phone
(440) 260-8453
Fax
(440) 260-8576
NPI assigned
Jan 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E-1954 OH Primary

Addresses

Primary practice location

3500 Carnegie Ave
Cleveland, OH 44115-2641

Mailing address

3500 Carnegie Ave
Cleveland, OH 44115-2641
Phone (440) 260-8453

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
I20240507002028 OH Practitioner - Mental Health Counselor 1355782459 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E-1954OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone Current Accepting new patients
Ohioguidestone CurrentSince Feb 7, 2024 Accepting new patients
Ohioguidestone CurrentSince Feb 7, 2024 Accepting new patients
Ohioguidestone Past Accepting new patients

Locations

434 Eastland Rd
Berea, OH 44017
Phone (440) 260-8327

202 E Bagley Rd
Berea, OH 44017
Phone (440) 260-8327

3500 Carnegie Ave
Cleveland, OH 44115
Phone (440) 260-8327

Organizations & group practices 4

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": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1891065405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 CARNEGIE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152641",
            "telephone_number": "440-260-8453",
            "fax_number": "440-260-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 CARNEGIE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152641",
            "telephone_number": "440-260-8453",
            "fax_number": "440-260-8576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "ANDREA",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E-1954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.