Kathleen Marie Allen, LPCC-S
Individual provider Active NPI Counselor · Mentor, OH
NPI 1922405331 · NPPES record last updated Jul 25, 2021
Key facts
- NPI
- 1922405331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- E.0002267-SUPV (OH)
- Practice address
- 7232 Justin Way
Mentor, OH 44060-4881 - Phone
- (440) 578-8200
- NPI assigned
- Dec 1, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240313003335 | OH | Practitioner - Mental Health Counselor | 3971949827 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.0002267-SUPV | OH | MD | Counselor |
| E0002267 | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signature Health, Inc. | Mental Health | Current |
Accepting new patients |
| Signature Health Inc | Current |
Accepting new patients | |
| Signature Health Inc. | Past | Accepting new patients | |
| Signature Health Inc. | Past | Accepting new patients |
Locations
21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100
7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855
38882 Mentor Ave
Willoughby, OH 44094
38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | E0002267 | OH | |
| Professional Counselor | 101YP2500X | E0002267 | OH | |
| Counselor | 101Y00000X | E.0002267-SUPV | OH | Yes |
Addresses
Primary practice location
7232 Justin Way
Mentor, OH 44060-4881
Mailing address
7232 Justin Way
Mentor, OH 44060-4881
Phone (440) 578-8200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0186306 | Medicaid | OH |
Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.