Marie Christine Klemens, MA. LPCC. LCDC III

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.2203154 Issued in OH

Practice address

601 Cleveland Ave NW
Canton, OH 44702-1836

Phone

(330) 455-0374

Fax

(330) 453-6716

NPI assigned

Aug 15, 2017

Last updated

Oct 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Springvale Health Centers,IncGroup PAC ID 4688616980, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HDGCDA

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.

• Springvale Health Centers, Inc

  • Mental Health Counselor
  • Dover, OH
  • NPI 1477508406
  Medicare reassignment Care Compare group NPD
• Cognitive Organics LLC

  • Community/Behavioral Health Agency
  • Bolivar, OH
  • NPI 1609493097
  Medicare reassignment NPD
• Cognitive Organics LLC

  • Mental Health Counselor
  • Bolivar, OH
  • NPI 1902664964
  NPD
• Springvale Health Centers,Inc

  • Federally Qualified Health Center (FQHC)
  • Dover, OH
  • NPI 1396577276
  NPD

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1922524735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021805",
            "telephone_number": "330-455-0374",
            "fax_number": "330-453-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021836",
            "telephone_number": "330-455-0374",
            "fax_number": "330-453-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEMENS",
        "first_name": "MARIE",
        "middle_name": "CHRISTINE",
        "credential": "MA. LPCC. LCDC III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII.161767",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2203154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0261366",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Odin Azazel Kisner
• Ceceilia Nichole Kissel, PA-C
• Raven Kiyota-Au
• Brianna D Kleckner, LPC
• Erika Kleis, CRC
• Eveline Rusdianto Klenotic, DO, FACS
• Gerald F Klimo, M.D.
• Jorja Kline
• Nicole Kline, OT
• Brenda E Klingelsmith, RN

• Professional Counselor in Canton, OH
• Providers in Canton, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.