Port45 Recovery LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PORT45 RECOVERY LLC

Practice address

1907 11TH St
Portsmouth, OH 45662-4531

Phone

(740) 529-7356

NPI assigned

Feb 18, 2020

Organization subpart

No

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

Authorized official

Name

Bryan McBride

Title

Financial Executive

Phone

(614) 591-4710

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sharon Staley, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Columbus, OH
  • NPI 1194205658

  Single Specialty

  NPD

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1053944033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 EASTWIND DR STE 101",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430815302",
            "telephone_number": "614-591-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 11TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624531",
            "telephone_number": "740-529-7356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Highview Blvd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432076023",
            "country_code": "US",
            "telephone_number": "614-826-9995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PORT45 RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "FINANCIAL EXECUTIVE",
        "authorized_official_telephone_number": "614-591-4710"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra K Poole
• Lisa G Poorman
• Luke T Porginski, ACNPC-AG
• Porsmouth Hospital Corporation
• Porsmouth Hospital Corporation
• Port45 Recovery LLC
• Kacee Porter, CDCA
• Portsmouth Al Opco LLC
• Portsmouth Ambulette Services
• Portsmouth City School District

• Mental Health Counselor in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.