Active NPI
Lawrence Daniel George, LPCC
- Professional Counselor
- Tiffin, OH
National Provider Identifier
1083663470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E0001996-SUPV
- Practice address
- 250 W Woodmere Dr
Tiffin, OH 44883-8937 - Phone
- (419) 447-3557
- NPI assigned
- May 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | E.0001966-SUPV | OH | |
| Professional Counselor | 101YP2500X | E0001996-SUPV | OH | Primary |
Addresses
Primary practice location
250 W Woodmere Dr
Tiffin, OH 44883-8937
Mailing address
250 W Woodmere Dr
Tiffin, OH 44883-8937
Phone (419) 447-3557
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000304312 | Other | OH | ANTHEM BLUE CROSS BLUE SH |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.0001966-SUPV | OH | MD | Mental Health Counselor |
| E0001996-SUPV | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital | Past | Accepting new patients | |
| Memorial Professional Services LTD | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501200000000",
"number": "1083663470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 W WOODMERE DR",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448838937",
"telephone_number": "419-447-3557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 W WOODMERE DR",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448838937",
"telephone_number": "419-447-3557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "LAWRENCE",
"middle_name": "DANIEL",
"name_prefix": "Mr.",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2017-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E.0001966-SUPV",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E0001996-SUPV",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS BLUE SH",
"identifier": "000000304312",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tiffin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.