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David Blaine

Peer Specialist • Lorain, OH

Active NPI 1942017017 Individual Practitioner Male Practitioner
Practice location in NPPES

6140 S Broadway
Lorain, OH 440533821

Call 4402337232 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

6140 S Broadway

Lorain, OH 440533821

Telephone 4402337232
Organization at the Same NPPES Address or Phone
Riveon Mental Health And Recovery Facility NPI 1841268281

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, “Does 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 Lorain and Ohio

58 active clinicians are listed under Peer Specialist with a practice address in Lorain, OH (3,082 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Lorain

0% of these 58 clinicians have the CMS telehealth indicator.

0% of these 58 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 · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-12-09
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

License # reported to NPPES OH APS.000193

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.

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

Clinicians Sharing This Practice Address or Phone

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

20 listed
Diana Adams , LSW

Social Worker

NPI 1841317203

Licensed Social Worker

Dr. Lorraine Christian , MD

Family Medicine - Adolescent Medicine

NPI 1376682104

Doctor of Medicine (M.D.)

Dr. Dominic Gomes , MD

Family Medicine - Adult Medicine

NPI 1144376856

Doctor of Medicine (M.D.)

Mary Harrison , MSN, RN, CS

Clinical Nurse Specialist - Psychiatric/Mental Health, Adult

NPI 1629006721

Master of Science in Nursing, Registered Nurse, CS

Tiffany Hayes , RN, APRN, CNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1760724215

Registered Nurse, Advanced Practice Registered Nurse, Certified Nurse Practitioner

Mackenzie Ice , MS, APRN, PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1730671405

Master of Science, Advanced Practice Registered Nurse, Psychiatric-Mental Health Nurse Practitioner (Board Certified)

Career & Practice History

NPI enumerated December 12, 2024.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2025 to August 2026.

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NPI Administrative Meta

NPI Number: 1942017017
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 12, 2024
Last Update: December 12, 2024
Sole Proprietor: Yes

Mailing Address

6140 South Broadway

Lorain, OH 440533821

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.