Active NPI
Lynette Marie Kreidler, LPCC
- Mental Health Counselor
- Fairlawn, OH
National Provider Identifier
1912323908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E1800662
- Practice address
- 150 N Miller Rd Ste 450
Fairlawn, OH 44333-3770 - Phone
- (330) 705-9521
- Fax
- (330) 705-9521
- NPI assigned
- Mar 14, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | E1800662 | OH | Primary |
Addresses
Primary practice location
150 N Miller Rd Ste 450
Fairlawn, OH 44333-3770
Mailing address
150 N Miller Rd Ste 450
Fairlawn, OH 44333-3770
Phone (330) 705-9521
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912323908 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E1800662 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1912323908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 N MILLER RD STE 450",
"city": "FAIRLAWN",
"state": "OH",
"postal_code": "443333770",
"telephone_number": "330-705-9521",
"fax_number": "330-705-9521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 N MILLER RD STE 450",
"city": "FAIRLAWN",
"state": "OH",
"postal_code": "443333770",
"telephone_number": "330-705-9521",
"fax_number": "330-705-9521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KREIDLER",
"first_name": "LYNETTE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-14",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E1800662",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912323908",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairlawn, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.