MICHAEL MACK (NPI# 1962995357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962995357 |
| Entity Type | Individual |
| Full Name | MICHAEL MACK |
| Practice Address |
8411 Broadway Ave Cleveland OH 44105-3932 |
| Practice Telephone | 2164410200 |
| Practice Fax Number | 2164413637 |
| Mailing Telephone | 2164410200 |
| Mailing Fax Number | 2164413637 |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2018-06-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851737589 | Michael George Mack | Chiropractor | 1327 Bay View Dr, Devils Lake, ND 58301-8629 | 2013-05-21 |
| 1710239876 | Michael Wesley Mack Jr. | Social Worker | 6605 Abercorn St Ste 101f, Savannah, GA 31405-5896 | 2012-10-12 |
| 1407138712 | Michael Mack | Registered Nurse | 5416 N Lawrence St, Philadelphia, PA 19120-2804 | 2011-09-13 |
| 1235298555 | Michael Edward Mack | Dentist | 7060 Spring Meadows W Dr, Suite B, Holland, OH 43528-8061 | 2006-12-06 |
| 1508952375 | Michael John Mack | Dentist | 40 E. Putnam Ave., Cos Cob, CT 06807 | 2006-10-05 |
| 1902356710 | Michael Anthony Mack | Counselor | 600 Bernard St, Bakersfield, CA 93305-3020 | 2016-10-05 |
| 1114333796 | Michael Mack | Counselor | 3450 Broadway St, Boulder, CO 80304-1824 | 2014-07-03 |
| 1245484948 | Michael Mack | Marriage & Family Therapist | 6041 Cadillac Ave, Los Angeles, CA 90034-1702 | 2008-11-07 |
| 1225216997 | Michael Dean Mack | Emergency Medicine | 4480 Utica Ridge Rd, Bettendorf, IA 52722-1644 | 2008-02-05 |
| 1376531913 | Michael J. Mack | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4708 Alliance Blvd, Suite 700, Pavillion I, Plano, TX 75093-5340 | 2005-10-07 |
| 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 | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606755 | Kathy Ann Miller | Case Manager/Care Coordinator | 296 Colony Ln Nw, Cleveland, TN 37312-6411 | 2020-10-14 |
| 1437766243 | Marie L Clay | Case Manager/Care Coordinator | 8200 Rosewood Ave # Up, Cleveland, OH 44105-6683 | 2020-09-25 |
| 1073123311 | King Malone IIi | Case Manager/Care Coordinator | 1193 E 172nd St, Cleveland, OH 44119-3153 | 2020-08-02 |
| 1750990727 | Reginald Bagley I | Case Manager/Care Coordinator | 2728 Euclid Ave Ste 4004th, Cleveland, OH 44115-2429 | 2020-07-27 |
| 1497364681 | James Gordon | Case Manager/Care Coordinator | 896 E 73rd St, Cleveland, OH 44103-1792 | 2020-07-24 |
| 1558988204 | Jamil Brooks | Case Manager/Care Coordinator | 23612 Mccann St, Cleveland, OH 44128-5250 | 2020-06-29 |
| 1629692801 | Theodore Williams Iv | Case Manager/Care Coordinator | 7271 Engle Rd Ste 207, Cleveland, OH 44130-8404 | 2020-06-03 |
| 1629690920 | Vincent Van Johnson | Case Manager/Care Coordinator | 17325 Euclid Ave Ste 4028, Cleveland, OH 44112-1270 | 2020-05-11 |
| 1932728508 | Janayia Thompson | Case Manager/Care Coordinator | 12395 Mccracken Rd # A-up, Cleveland, OH 44125-2967 | 2020-04-13 |
| 1942836309 | Shirley Tucker | Case Manager/Care Coordinator | 2728 Euclid Ave, Cleveland, OH 44115-2429 | 2020-03-18 |
| 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.