Individual provider Active NPI

Sabrina Jones, LCDC111

  • Addiction (Substance Use Disorder) Counselor
  • Lorain, OH
National Provider Identifier
1003277765
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
081196-3 Issued in OH
Practice address
2115 West Park Drive
Lorain, OH 44053
Phone
(440) 989-4987
Fax
(440) 282-4779
NPI assigned
Mar 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 081196-3 OH Primary

Addresses

Primary practice location

2115 West Park Drive
Lorain, OH 44053

Mailing address

2115 West Park Drive
Lorain, OH 44053
Phone (440) 989-4987

Other identifiers 1

IdentifierTypeStateIssuer
LICDC.161639OtherOHLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
081196-3OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1003277765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 WEST PARK DRIVE",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "44053",
            "telephone_number": "440-989-4987",
            "fax_number": "440-282-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 WEST PARK DRIVE",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "44053",
            "telephone_number": "440-989-4987",
            "fax_number": "440-282-4779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SABRINA",
        "credential": "LCDC111",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-09",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "081196-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LICDC.161639",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.