Individual provider Active NPI

Shari Ann Borgeson, LPC

  • Professional Counselor
  • Medina, OH
National Provider Identifier
1932424892
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0002805-SUPV Issued in OH
Practice address
246 Northland Dr Ste 200a
Medina, OH 44256-3440
Phone
(330) 725-9195
NPI assigned
Apr 5, 2010
Last updated
Jun 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.161345 OH
Professional Counselor 101YP2500X E.0002805-SUPV OH Primary

Addresses

Primary practice location

246 Northland Dr Ste 200a
Medina, OH 44256-3440

Mailing address

246 Northland Dr Ste 200a
Medina, OH 44256-3440
Phone (330) 725-9195

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
I20240123002648 OH Practitioner - Mental Health Counselor 8729430939 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICDC.161345OHMDAddiction (Substance Use Disorder) Counselor
E.0002805-SUPVOHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alternative Paths Inc. CurrentSince Jan 1, 2024 Accepting new patients
Alternative Paths, Inc. Addiction (Substance Use Disorder) CurrentSince Jan 1, 2024 Accepting new patients

Locations

246 Northland Dr
Ste 200A
Medina, OH 44256
Phone (330) 725-9195

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1932424892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 NORTHLAND DR STE 200A",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442563440",
            "telephone_number": "330-725-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 NORTHLAND DR STE 200A",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442563440",
            "telephone_number": "330-725-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORGESON",
        "first_name": "SHARI",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161345",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0002805-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

Verify at the official NPI Registry.