Individual provider Active NPI

Willard D Dearmond Jr.

  • Social Worker
  • Springfield, OH
National Provider Identifier
1053967240
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.2607960 Issued in OH
Practice address
2624 Lexington Ave
Springfield, OH 45505-2620
Phone
(937) 328-5300
Fax
(937) 322-4900
NPI assigned
Aug 13, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I.2607960 OH Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.162479 OH

Addresses

Primary practice location

2624 Lexington Ave
Springfield, OH 45505-2620

Mailing address

2624 Lexington Ave
Springfield, OH 45505-2620
Phone (937) 328-5300

Other practice location 1

2213 N Limestone St
Springfield, OH 45503-2635
Phone (937) 399-4431

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
LICDC.162479OHMDAddiction (Substance Use Disorder) Counselor
I.2607960OHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1053967240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 LEXINGTON AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455052620",
            "telephone_number": "937-328-5300",
            "fax_number": "937-322-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 LEXINGTON AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455052620",
            "telephone_number": "937-328-5300",
            "fax_number": "937-322-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2213 N Limestone St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455032635",
            "country_code": "US",
            "telephone_number": "937-399-4431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEARMOND",
        "first_name": "WILLARD",
        "middle_name": "D",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-13",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.2607960",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162479",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.