Individual provider Active NPI

Marketa Robinson, LCDC III

  • Addiction (Substance Use Disorder) Counselor
  • Dayton, OH
National Provider Identifier
1023491271
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
141200-3 Issued in OH
Practice address
1 Elizabeth PL
Dayton, OH 45417-3445
Phone
(937) 276-2176
Fax
(937) 276-2048
NPI assigned
Jul 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 141200-3 OH Primary

Addresses

Primary practice location

1 Elizabeth PL
Dayton, OH 45417-3445

Mailing address

1 Elizabeth PL.
RT-1
Dayton, OH 45417-1054
Phone (937) 276-2176

Other practice location 1

809 W Vine St
Lima, OH 45804-1054
Phone (419) 222-4474

Other identifiers 1

IdentifierTypeStateIssuer
0203698MedicaidOH

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
141200-3OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Umadaop Current Accepting new patients
Urban Minority Alcoholism & Drug Abuse Outreach Program CurrentSince Jun 30, 2024 Accepting new patients

Locations

1 Elizabeth Pl
#1
Dayton, OH 45417
Phone (937) 276-2176

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1023491271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL.",
            "address_2": "RT-1",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454171054",
            "telephone_number": "937-276-2176",
            "fax_number": "937-276-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173445",
            "telephone_number": "937-276-2176",
            "fax_number": "937-276-2048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 W Vine St",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458041054",
            "country_code": "US",
            "telephone_number": "419-222-4474",
            "fax_number": "419-222-7044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "MARKETA",
        "name_prefix": "Ms.",
        "credential": "LCDC III",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "141200-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0203698",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.