Regina Edmondson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LICDC-CS.162193 Issued in OH

Practice address

155 Montrose West Ave
Copley, OH 44321-3121

Phone

(330) 993-4649

NPI assigned

Jun 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Stella Maris, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cleveland, OH
  • NPI 1467598391

  OH

  Medicare reassignment NPD
• Stella Maris, Inc.

  • Adult Mental Health Clinic/Center
  • Cleveland, OH
  • NPI 1487927802
  NPD

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787961600000",
    "number": "1013575919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 ROSEWOOD DR APT E104",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440351859",
            "telephone_number": "440-522-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MONTROSE WEST AVE",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443213121",
            "telephone_number": "330-993-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "REGINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2026-08-29",
        "certification_date": "2026-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC-CS.162193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Dixon, RBT
• Jillian Douglass, MOT, OTR/L
• Cammeron William Drager
• Darlene Ducksworth
• Salima R. Dunn
• Empowered Transit LLC
• Kelly Fasig, DPT
• William James Fihe, DDS
• Stacy Flaisman
• Grace Lynn Fluty, MAE.D., LPCC

• All providers in Copley, OH
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.