NPIMap

Organization Active NPI

Theravault, LLC

  • Mental Health Counselor
  • Powell, OH
National Provider Identifier
1922674563
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
THERAVAULT, LLC
Practice address
185 S Liberty St
Powell, OH 43065-7619
Phone
(888) 875-8712
NPI assigned
Jun 3, 2021
Last updated
Aug 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Authorized official

Name
Amy Smitke, LISW-S, LICDCNPI 1730561036
Title
Co-Owner
Phone
(888) 875-8712

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

185 S Liberty St
Powell, OH 43065-7619

Mailing address

7736 Birchmont Dr
Chagrin Falls, OH 44022-3970
Phone (888) 875-8712

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.google.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

600 E Granger Rd
Ste 200
Brooklyn Heights, OH 44131

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1922674563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7736 BIRCHMONT DR",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440223970",
            "telephone_number": "888-875-8712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 S LIBERTY ST",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430657619",
            "telephone_number": "888-875-8712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAVAULT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-03",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "SMITKE",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "888-875-8712",
        "authorized_official_credential": "LISW-S, LICDC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.google.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "185 S Liberty St",
            "city": "Powell",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430657619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Powell, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.