Individual provider Active NPI

Miabrit Larson, LPC

  • Professional Counselor
  • Lakewood, OH
National Provider Identifier
1962934745
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C1500249 Issued in OH
Practice address
15644 Madison Ave Ste 104
Lakewood, OH 44107-5622
Phone
(440) 234-2006
NPI assigned
Mar 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C1500249 OH Primary

Addresses

Primary practice location

15644 Madison Ave Ste 104
Lakewood, OH 44107-5622

Mailing address

15644 Madison Ave Ste 104
Lakewood, OH 44107-5622

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
I20251015000909 OH Practitioner - Mental Health Counselor 0244727014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OhioguidestoneGroup PAC ID 5597910935, 60 clinicians

Practice addresses (Care Compare)

434 Eastland Rd
Berea, OH 44017-1217
Phone (440) 260-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C1500249OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone CurrentSince Aug 3, 2025 Accepting new patients
Ohioguidestone Current Accepting new patients
Ohioguidestone CurrentSince Aug 3, 2025 Accepting new patients
Ohioguidestone Past Accepting new patients

Locations

434 Eastland Rd
Berea, OH 44017
Phone (440) 260-8327

202 E Bagley Rd
Berea, OH 44017
Phone (440) 260-8327

15644 Madison Ave
Ste 104
Lakewood, OH 44107
Phone (440) 260-6106

Organizations & group practices 4

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1962934745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15644 MADISON AVE STE 104",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441075622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15644 MADISON AVE STE 104",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441075622",
            "telephone_number": "440-234-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "MIABRIT",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C1500249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

Verify at the official NPI Registry.