Individual provider Active NPI

Chelsea Dawn Puda, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Cleveland, OH
National Provider Identifier
1083133896
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.164576 Issued in OH
Practice address
1302 Winslow Ave
Cleveland, OH 44113-2336
Phone
(216) 781-0550
Fax
(216) 771-1563
NPI assigned
Sep 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X CDCA.164576 OH Primary

Addresses

Primary practice location

1302 Winslow Ave
Cleveland, OH 44113-2336

Mailing address

30800 Chagrin Blvd.
Cleveland, OH 44124
Phone (216) 591-0324

Other identifiers 1

IdentifierTypeStateIssuer
2374229MedicaidOH

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
CDCA.164576OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1083133896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30800 CHAGRIN BLVD.",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44124",
            "telephone_number": "216-591-0324",
            "fax_number": "216-591-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 WINSLOW AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441132336",
            "telephone_number": "216-781-0550",
            "fax_number": "216-771-1563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUDA",
        "first_name": "CHELSEA",
        "middle_name": "DAWN",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.164576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2374229",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.