Tyrena Depp, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.170607 Issued in OH

Practice address

500 Madison Ave Unit 5
Toledo, OH 43604-1222

Phone

(419) 690-4544

NPI assigned

Dec 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Benchmark Behavioral Healthcare, Inc

  • Community/Behavioral Health Agency
  • Toledo, OH
  • NPI 1265919831
  NPD (past)

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1013554039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 SLATER ST APT 103",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436122762",
            "telephone_number": "419-380-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MADISON AVE UNIT 5",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041222",
            "telephone_number": "419-690-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPP",
        "first_name": "TYRENA",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.170607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apatterson@benchmarkbehavioralhc.com",
            "affiliation": "N",
            "endpointDescription": "Email Address",
            "address_1": "500 Madison Ave Unit 5",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Department of Veterans Affairs VA Ann Arbor Healthcare System
• Cyrano Jamal Depp V, QBHS
• Ebony Depp
• Tamara Depp
• Tiffany Depp, CDCA,QMHS
• Arianna Deppen
• Mary E Derck, ATC
• Corvette R Derden
• Kacynthia Derden, STNA
• Raquel Derian

• Addiction (Substance Use Disorder) Counselor in Toledo, OH
• Providers in Toledo, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.