COLIN JAMES CLEGG (NPI# 1588219190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588219190 |
| Entity Type | Individual |
| Full Name | COLIN JAMES CLEGG |
| Credential | CDCA |
| Practice Address |
30800 Chagrin Blvd Cleveland OH 44124-5925 |
| Practice Telephone | 2165911253 |
| Mailing Telephone | 2165911253 |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2020-01-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CDCA.171039 | OH | Behavioral Health & Social Service Providers |
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2864093 | 05 |
| Street Address |
30800 CHAGRIN BLVD |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44124-5925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649298613 | Melissa K Lammi | Counselor | 30800 Chagrin Blvd, Cleveland, OH 44124-5925 | 2006-07-18 |
| 1922612548 | Tiffany Delila Mims | Social Worker | 30800 Chagrin Blvd, Cleveland, OH 44124-5925 | 2020-09-01 |
| 1376001040 | Andrea Elaine Parra | Community/Behavioral Health | 30800 Chagrin Blvd, Cleveland, OH 44124-5925 | 2019-03-12 |
| 1154889541 | Donna Lee Walter-quayle | Community/Behavioral Health | 30800 Chagrin Blvd, Cleveland, OH 44124-5925 | 2019-03-05 |
| 1720546054 | Kaylee Ann Boney | Community/Behavioral Health | 30800 Chagrin Blvd, Cleveland, OH 44124-5925 | 2019-03-05 |
| 1578031050 | Dwight Phinizee II | Community/Behavioral Health | 30800 Chagrin Blvd, Cleveland, OH 44124-5925 | 2018-11-02 |
| 1760976625 | Charles Jubell | Counselor | 30800 Chagrin Blvd, Cleveland, OH 44124-5925 | 2018-06-14 |
| 1073029864 | Steven E Wallace | Community/Behavioral Health | 30800 Chagrin Blvd, Cleveland, OH 44124-5925 | 2017-12-16 |
| 1124547302 | Tymira Angelique Stenson | Community/Behavioral Health | 30800 Chagrin Blvd, Cleveland, OH 44124-5925 | 2017-09-19 |
| 1467971911 | Kernesha L Greene | Community/Behavioral Health | 30800 Chagrin Blvd, Cleveland, OH 44124 | 2017-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104470509 | Marian Rae Barton | Physician Assistant | 6092 Mayfield Rd, Mayfield Heights, OH 44124 | 2019-07-25 |
| 1831669860 | Tameka D. Weaver | Home Health Aide | 1408 Golden Gate Blvd, Mayfield Hts, OH 44124 | 2018-12-03 |
| 1508371238 | Jamila Shafawn Hardy | Counselor | 1320 Washington Blvd, Cleveland, OH 44124 | 2017-12-04 |
| 1134664899 | Sergio Watson | Licensed Practical Nurse | 1131 Irene Rd, Lyndhurst, OH 44124 | 2017-01-04 |
| 1164894424 | Carrie Lynn Rodick | Registered Nurse | 1212 Blanchester, Lyndhurst, OH 44124 | 2015-10-27 |
| 1205205804 | Mary Rose Moore | Nurse Practitioner | 1443 Richmond Road, Lyndhurst, OH 44124 | 2015-09-24 |
| 1154717551 | Hongfei Di | Family Medicine | 5187 Mayfield Rd Ste 102, Lyndhurst, OH 44124 | 2015-04-13 |
| 1558753376 | Taj Amjad Khan | Pediatrics | 32810 Creekside Drive, Pepper Pike, OH 44124 | 2015-03-03 |
| 1902297195 | Marcellus Gliha | Hearing Instrument Specialist | 1438 S.o.m. Center Rd, #101, Mayfield Heights, OH 44124 | 2015-02-10 |
| 1194122051 | Doug Blecher | Counselor | 5512 Kilbourne Dr, Cleveland, OH 44124 | 2014-11-20 |
| Find all providers in zip 44124 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396345989 | Kyle Johnston | Peer Specialist | 10525 Clifton Blvd Apt 3, Cleveland, OH 44102-1586 | 2020-11-01 |
| 1972101012 | Cindy Ann Kozlik | Peer Specialist | 600 W.superior Ave, Cleveland, OH 44113 | 2020-10-12 |
| 1053918565 | Tina Louise Neal | Peer Specialist | 3637 Green Rd, Cleveland, OH 44122-5779 | 2020-10-07 |
| 1326645805 | Kristen Krajewski | Peer Specialist | 3105 Woodbridge Ave, Cleveland, OH 44109-2175 | 2020-10-07 |
| 1538774153 | Sarah Louise Woodside | Peer Specialist | 4478 S Hills Dr, Cleveland, OH 44109-4479 | 2020-09-10 |
| 1003421819 | Loretta Wilson | Peer Specialist | 3018 E 128th St, Cleveland, OH 44120-3003 | 2020-09-09 |
| 1558975128 | Jessica Ann Bair | Peer Specialist | 4606 Gifford Ave, Cleveland, OH 44144-2944 | 2020-09-01 |
| 1407460280 | Shiyla Ann Nix | Peer Specialist | 2230 E 82nd St, Cleveland, OH 44103-5008 | 2020-08-31 |
| 1538772611 | Ross Hilaszek | Peer Specialist | 2001 Willowdale Ave, Cleveland, OH 44109-2838 | 2020-08-28 |
| 1760008254 | Sober First, LLC | Peer Specialist | 4415 Euclid Ave Ste 204, Cleveland, OH 44103-3758 | 2020-06-19 |
| Find all providers in CLEVELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.