Individual provider Active NPI

Shannon McCreary, LPCCS CDCA

  • Counselor
  • Ravenna, OH
National Provider Identifier
1902356348
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
771 N Freedom St
Ravenna, OH 44266-2470
Phone
(330) 296-5552
NPI assigned
Oct 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.1901218-SUPV OH
Counselor 101Y00000X Primary

Addresses

Primary practice location

771 N Freedom St
Ravenna, OH 44266-2470

Mailing address

771 N Freedom St
Ravenna, OH 44266-2470

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
I20251120002394 OH Practitioner - Mental Health Counselor 7618469321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3201 Enterprise Pkwy
Suite 370
Beachwood, OH 44122-7337

PO Box
Cleeveland, OH 44193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.1901218-SUPVOHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Axess Family Services Inc CurrentSince Sep 3, 2025 Accepting new patients
Axess Family Services Inc CurrentSince Sep 3, 2025 Accepting new patients
Axess Family Services Inc Current Accepting new patients

Locations

1400 S Arlington St
Unit 38
Akron, OH 44306
Phone (330) 724-5471

390 Robinson Ave
Ste E
Barberton, OH 44203
Phone (330) 564-2697

771 N Freedom St
Ravenna, OH 44266
Phone (330) 296-5552

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1902356348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 N FREEDOM ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442662470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 N FREEDOM ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442662470",
            "telephone_number": "330-296-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCREARY",
        "first_name": "SHANNON",
        "credential": "LPCCS CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1901218-SUPV",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

Verify at the official NPI Registry.