KEVIN STALLER (NPI# 1659826154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659826154 |
| Entity Type | Individual |
| Full Name | KEVIN STALLER |
| Credential | LPC |
| Practice Address |
8411 Broadway Ave Cleveland OH 44105-3932 |
| Practice Telephone | 2162065201 |
| Practice Fax Number | 2164413637 |
| Mailing Telephone | 2162065201 |
| Mailing Fax Number | 2164413637 |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
C.1500314 | OH | Behavioral Health & Social Service Providers |
| Street Address |
8411 BROADWAY AVE |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44105-3932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497871719 | Community Assessment and Treatment Services, Inc | Substance Abuse Rehabilitation Facility | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2007-03-21 |
| 1134720055 | Kelitha Laverne Bivens | Counselor | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2020-11-06 |
| 1659972651 | Nakita Eathridge | Behavioral Analyst | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2020-11-05 |
| 1386245736 | Mary Margaret Mathis | Counselor | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2020-11-03 |
| 1851907893 | Kathryn Rebecca Sass | Counselor | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2020-09-16 |
| 1376156505 | Randra Simkins | Counselor | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2020-08-27 |
| 1316550924 | Matthew K Stewart | Counselor | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2020-08-25 |
| 1265045702 | Robert Williams | Counselor | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2020-08-25 |
| 1023620937 | Kent Obrian Strain | Behavior Technician | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2020-08-21 |
| 1659981900 | Darryl Childress | Counselor | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2020-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710525340 | Horitta R Yelder | Nurse's Aide | 11305 Olney Ct., Cleveland, OH 44105 | 2019-12-13 |
| 1063982643 | Jasmine Harris | Case Manager/Care Coordinator | 6410 S Broadway, Lorain, OH 44105 | 2018-11-27 |
| 1629596556 | Amber M Stinnett | Licensed Practical Nurse | 11322 Matilda Ave., Cleveland, OH 44105 | 2017-08-30 |
| 1154848752 | Latisha A Coleman | Homemaker | 4151 East 106st, Cleveland, OH 44105 | 2017-08-24 |
| 1235651605 | Christina Roberson | Nurse's Aide | 3525 E.106 St, Cleveland, OH 44105 | 2017-07-07 |
| 1982139457 | Robert Lucas | Homemaker | 9122 Miles, Cleveland, OH 44105 | 2017-04-21 |
| 1154719243 | Sabrina L Kirksey | Driver | 7414 Park Avenue, Cleveland, OH 44105 | 2014-12-26 |
| 1518379643 | Hope Academy Northcoast Campus | Local Education Agency (LEA) | 4310 E. 71st Street, Cleveland, OH 44105 | 2014-05-23 |
| 1366853301 | Gabrielle Baker | Contractor | 4071 E. 59th St., Cleveland, OH 44105 | 2014-05-13 |
| 1407266174 | Hermine Christine Terry | Nurse's Aide | 4096 E. 81 Street, Cleveland, OH 44105 | 2014-05-05 |
| Find all providers in zip 44105 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203246 | Kimberly Fuller, Lisw, LLC | Counselor | 2291 W 38th St, Cleveland, OH 44113-3867 | 2020-10-19 |
| 1255930467 | Jessica Becka LLC | Counselor | 5206 Tillman Ave, Cleveland, OH 44102-2248 | 2020-10-19 |
| 1629675541 | Shayna Mell | Counselor | 4542 Wilburn Dr, Cleveland, OH 44121-3863 | 2020-10-04 |
| 1316552649 | Monisa Ramseur | Counselor | 2800 Euclid Ave Ste 335, Cleveland, OH 44115-2496 | 2020-09-14 |
| 1164031076 | Michele R Princeton | Counselor | 3846 E 65th St, Cleveland, OH 44105-3560 | 2020-07-27 |
| 1700407517 | Cornerstone Behavioral Health LLC | Counselor | 814 E 185th Street, Suite 300, Cleveland, OH 44119 | 2020-05-04 |
| 1811522337 | Mary Cassidy | Counselor | 4128 Lorain Ave, Cleveland, OH 44113-3719 | 2020-03-04 |
| 1285272963 | Theophilus Nikia Williams | Counselor | 3521 W 54th St, Cleveland, OH 44102-5709 | 2019-12-13 |
| 1467098822 | Jordan Community Residential | Counselor | 2231 N Taylor Rd, Cleveland, OH 44112-3044 | 2019-11-20 |
| 1285275529 | Anchor Warrior Center | Counselor | 3505 Adkisson Dr Nw Ste 156, Cleveland, TN 37312-6823 | 2019-10-07 |
| 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.