Mickey A Babcock, CDCA
Individual provider Active NPI Case Manager/Care Coordinator · Ironton, OH
NPI 1013483973 · NPPES record last updated Nov 6, 2020
Key facts
- NPI
- 1013483973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- License
- CDCA.174799 (OH)
- Practice address
- 700 Park Ave
Ironton, OH 45638 - Phone
- (740) 532-1613
- Fax
- (740) 532-1715
- NPI assigned
- Oct 18, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.170860 | OH | MD | Case Manager/Care Coordinator |
| CDCA.174799 | OH | MD | Case Manager/Care Coordinator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | CDCA.170860 | OH | |
| Case Manager/Care Coordinator | 171M00000X | CDCA.174799 | OH | Yes |
Addresses
Primary practice location
700 Park Ave
Ironton, OH 45638
Mailing address
PO Box 108
Ironton, OH 45638-0108
Phone (740) 532-1613
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0356353 | Medicaid | OH |
Other providers in Ironton, OH
- Amanda Assi
- Hassan Assi
- Allison Aufderhaar
- Alisa Austin
- Jacinda Babcock
- Olivia Bailey-Sprankle
- Alexis Danielle Bailey
- Amanda Dawn Baker
- Cheromi Joyce Baker
- Dana Baker
All providers in Ironton, OH · Case Manager/Care Coordinator in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.