NPIMap

Organization Active NPI

Proud to Be, Inc

  • Community/Behavioral Health Agency
  • Cleveland, OH
National Provider Identifier
1992577076
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PROUD TO BE, INC
Practice address
11811 Shaker Blvd Ste 123
Cleveland, OH 44120-1927
Phone
(216) 242-2990
NPI assigned
Oct 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Authorized official

Name
Lisa Sullivan
Title
Credentialing Specialist
Phone
(440) 453-0754

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

11811 Shaker Blvd Ste 123
Cleveland, OH 44120-1927

Mailing address

11811 Shaker Blvd Ste 123
Cleveland, OH 44120-1927

National Provider Directory

National Provider Directory
Tax ID family
Proud to Be Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1992577076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11811 SHAKER BLVD STE 123",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11811 SHAKER BLVD STE 123",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201927",
            "telephone_number": "216-242-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROUD TO BE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "440-453-0754"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.