Individual provider Active NPI

James Schultz II, LICDC-CS

  • Addiction (Substance Use Disorder) Counselor
  • Perrysburg, OH
National Provider Identifier
1053785584
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
933692 Issued in OH
Practice address
1090 W South Boundary St
Suite 600
Perrysburg, OH 43551-5234
Phone
(419) 873-8280
Fax
(419) 873-8320
NPI assigned
Nov 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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 933692 OH Primary

Addresses

Primary practice location

1090 W South Boundary St
Suite 600
Perrysburg, OH 43551-5234

Mailing address

1090 W South Boundary St
Suite 600
Perrysburg, OH 43551-5234
Phone (419) 873-8280

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250715003446 OH Practitioner - Mental Health Counselor 0648785915 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
933692OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Team Recovery Ohio, LLC CurrentSince May 2, 2025 Accepting new patients
Team Recovery Ohio, LLC CurrentSince May 2, 2025 Accepting new patients
Talbot Clinical Services of Ohio LLC Past Accepting new patients
Talbot Clinical Services of Ohio LLC Past Accepting new patients

Locations

4888 Whiteford Rd
Toledo, OH 43623
Phone (419) 561-5433

4352 W Sylvania Ave
Toledo, OH 43623
Phone (419) 561-5433

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/theteamrecovery/r4/

Organizations & group practices 4

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": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1053785584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 W SOUTH BOUNDARY ST",
            "address_2": "SUITE 600",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515234",
            "telephone_number": "419-873-8280",
            "fax_number": "419-873-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 W SOUTH BOUNDARY ST",
            "address_2": "SUITE 600",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515234",
            "telephone_number": "419-873-8280",
            "fax_number": "419-873-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "JAMES",
        "name_suffix": "II",
        "credential": "LICDC-CS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "933692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.