Active NPI
Daveanna Joella Masters
- Addiction (Substance Use Disorder) Counselor
- Vienna, WV
National Provider Identifier
1023844867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 189807
- Practice address
- 912 21St St Apt B
Vienna, WV 26105-1318 - Phone
- (810) 252-2494
- NPI assigned
- Sep 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 189807 | OH | Primary |
Addresses
Primary practice location
912 21St St Apt B
Vienna, WV 26105-1318
Mailing address
912 21St St Apt B
Vienna, WV 26105-1318
Phone (810) 252-2494
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
| License | State | Type | Specialty |
|---|---|---|---|
| 189807 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1023844867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "912 21ST ST APT B",
"city": "VIENNA",
"state": "WV",
"postal_code": "261051318",
"telephone_number": "810-252-2494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 21ST ST APT B",
"city": "VIENNA",
"state": "WV",
"postal_code": "261051318",
"telephone_number": "810-252-2494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTERS",
"first_name": "DAVEANNA",
"middle_name": "JOELLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-09",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "189807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.