Mental Health Lifestyle LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I 1440201 SUPV Issued in OH

Legal business name

MENTAL HEALTH LIFESTYLE LLC

Practice address

20525 Center Ridge Rd
Suite 303
Rocky River, OH 44116-3437

Phone

(440) 574-1794

NPI assigned

Aug 21, 2015

Organization subpart

No

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

Authorized official

Name

Alissa Wible, LISW-SNPI 1255612628

Title

Owner

Phone

(440) 574-1794

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alissa S Wible, LISW-S

  • Clinical Social Worker
  • Rocky River, OH
  • NPI 1255612628
  NPD (past) Authorized official

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440115200000",
    "number": "1952778243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2181 BRIARWOOD RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441182833",
            "telephone_number": "440-574-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20525 CENTER RIDGE RD",
            "address_2": "SUITE 303",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163437",
            "telephone_number": "440-574-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH LIFESTYLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-21",
        "last_updated": "2015-08-21",
        "status": "A",
        "authorized_official_last_name": "WIBLE",
        "authorized_official_first_name": "ALISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-574-1794",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 1440201 SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Louse McNamee, PH.D.
• Meadow Falls Rocky River Opco LLC
• Medadvice LLC
• John P Meehan, LPCC
• Elisaida Mendez, PHD
• Emma Joanna Miller, OTD
• Susan Lynn Millward, R.PH.
• Ellen M Minerd, CNP
• Johnna Miska, LPCC
• Alexander Jon Paynter Moir

• Clinical Social Worker in Rocky River, OH
• Providers in Rocky River, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; 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.