Individual provider Active NPI

Maria Shine Stewart, L.P.C.C.

  • Professional Counselor
  • Pepper Pike, OH
National Provider Identifier
1942688759
Registry record updated Mar 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2001987 Issued in OH
Practice address
29125 Chagrin Blvd.
Pepper Pike, OH 44122
Phone
(216) 292-3999
NPI assigned
May 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.2001987 OH Primary
Counselor 101Y00000X C1200349 OH

Addresses

Primary practice location

29125 Chagrin Blvd.
Pepper Pike, OH 44122

Mailing address

1006 Bryan Dr
South Euclid, OH 44121-3886
Phone (216) 382-4628

Other practice location 1

1006 Bryan Dr Ste 202
South Euclid, OH 44121-3886
Phone (216) 382-4628

Other practice location 2

1006 Bryan Dr
South Euclid, OH 44121-3886
Phone (216) 543-4891

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
I20240111004594 OH Practitioner - Mental Health Counselor 1254782428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

29125 Chagrin Blvd
Beachwood, OH 44122-4609
Phone (216) 292-3999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C1200349OHMDCounselor
E.2001987OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family Service Association CurrentSince Jan 1, 2024 Accepting new patients
Jewish Family Service Association CurrentSince Jan 1, 2024 Accepting new patients

Locations

29125 Chagrin Blvd
Beachwood, OH 44122
Phone (216) 504-6476

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615593600000",
    "number": "1942688759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 BRYAN DR",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441213886",
            "telephone_number": "216-382-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29125 CHAGRIN BLVD.",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-292-3999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1006 Bryan Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "South Euclid",
            "state": "OH",
            "postal_code": "441213886",
            "country_code": "US",
            "telephone_number": "216-382-4628",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1006 Bryan Dr",
            "address_purpose": "LOCATION",
            "city": "South Euclid",
            "state": "OH",
            "postal_code": "441213886",
            "country_code": "US",
            "telephone_number": "216-543-4891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MARIA",
        "middle_name": "SHINE",
        "name_prefix": "Ms.",
        "credential": "L.P.C.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2021-03-13",
        "certification_date": "2021-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2001987",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C1200349",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pepper Pike, OH

Sources for this page

Verify at the official NPI Registry.