Paul Timothy Waldroop II, LPC,LICDC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C.2203963 Issued in OH

Practice address

705 S Brown School Rd
Vandalia, OH 45377-3113

Phone

(937) 890-5400

Fax

(937) 890-5401

NPI assigned

Apr 6, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/recoveryworkshealingcenter/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Recovery Works Holding Company LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dayton, OH
  • NPI 1376910505
  NPD (past)
• Recovery Works Holding Company LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dayton, OH
  • NPI 1801316971
  NPD (past)

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1003313172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S BROWN SCHOOL RD",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453773113",
            "telephone_number": "937-890-5400",
            "fax_number": "937-890-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S BROWN SCHOOL RD",
            "city": "VANDALIA",
            "state": "OH",
            "postal_code": "453773113",
            "telephone_number": "937-890-5400",
            "fax_number": "937-890-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDROOP",
        "first_name": "PAUL",
        "middle_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LPC,LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162520",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2203963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christi Vann
• Viaquest Home Health, LLC
• Donna J Vogel, APRN.CNP
• Brittany An Voland, FNP-C
• Thomas Christopher Volck, D.D.S.
• Jennifer N Wallace, PTA
• Melissa Walters, LPN
• Deja M Waters
• Christie Lynn Watson Schmitt
• Wellness for Me, LLC

• Professional Counselor in Vandalia, OH
• Providers in Vandalia, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.