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Damien Anderson , SWT

Student in an Organized Health Care Education/Training Program β€’ Shaker Heights, OH

Active NPI 1811719115 Individual Practitioner Male Practitioner
Practice location in NPPES

22001 Fairmount Blvd
Shaker Heights, OH 441184819

Call 2169322800 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

22001 Fairmount Blvd

Shaker Heights, OH 441184819

Telephone 2169322800
Organization at the Same NPPES Address or Phone
Bellefaire Jewish Children's Bureau Facility NPI 1205893070

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2024

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Shaker Heights and Ohio

48 active clinicians are listed under Student in an Organized Health Care Education/Training Program with a practice address in Shaker Heights, OH (12,162 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Shaker Heights

0% of these 48 clinicians have the CMS telehealth indicator.

0% of these 48 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-10-05
Student in an Organized Health Care Education/Training Program Primary Specialty

NUCC Taxonomy Code: 390200000X

License # reported to NPPES OH S.2604951-TRNE

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
2910854 (OH)

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

3 listed
Miranda Barnhart , CNP

Nurse Practitioner - Family

NPI 1437899283

Certified Nurse Practitioner

Kerry Katz , LISW-S

Social Worker - Clinical

NPI 1003119942

LISWS

Dr. Eric Wallace , PhD

Psychologist - Counseling

NPI 1912409160

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
πŸ“
Updated Practice Location October 05, 2026

Registered at 22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 441184819 (Tel: 2169322800)

πŸ“
Updated Business Mailing Address October 05, 2026

Registered at 22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 441184819 (Tel: 2169322800)

πŸ‘€
Provider Name / Credentials Updated October 05, 2026

Recorded as DAMIEN ANDERSON, SWT

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 05, 2026

Student in an Organized Health Care Education/Training Program (license number reported to NPPES: OH S.2604951-TRNE)

βœ…
NPI Profile Active October 28, 2024

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 28, 2024

Registered at 525 METRO PL N STE 300, DUBLIN, OH 430175320 (Tel: 8552891722)

πŸ“
Business Mailing Address (Initial Record) October 28, 2024

Registered at 525 METRO PL N STE 300, DUBLIN, OH 430175320 (Tel: 8552891722)

πŸ‘€
Provider Name / Credentials (Initial Record) October 28, 2024

Recorded as DAMIEN ANDERSON

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 28, 2024

Case Manager/Care Coordinator

🟒
Initial NPI Registration & Enumeration October 28, 2024

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1811719115
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 28, 2024
Last Update: October 05, 2026
Sole Proprietor: Yes

Mailing Address

22001 Fairmount Blvd

Shaker Heights, OH 441184819

Phone: 2169322800

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.