NPIMap

Individual provider Active NPI

Deidre L. Brooke, PC

  • Professional Counselor
  • Newark, OH
National Provider Identifier
1083968754
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C.0800136 Issued in OH
Practice address
65 Messimer Dr
Newark, OH 43055-1874
Phone
(740) 522-8477
Fax
(740) 788-3424
NPI assigned
Nov 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C.0800136-CR OH
Professional Counselor 101YP2500X C.0800136 OH Primary

Addresses

Primary practice location

65 Messimer Dr
Newark, OH 43055-1874

Mailing address

PO Box 4670
Newark, OH 43058-4670
Phone (740) 522-8477

Other names 1

  • Deidre L. Stohr Former name

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
C.0800136OHMDProfessional Counselor
C.0800136-CROHMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1351814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1083968754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4670",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430584670",
            "telephone_number": "740-522-8477",
            "fax_number": "740-788-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MESSIMER DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551874",
            "telephone_number": "740-522-8477",
            "fax_number": "740-788-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKE",
        "first_name": "DEIDRE",
        "middle_name": "L.",
        "credential": "PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-02",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.0800136-CR",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.0800136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEIDRE",
            "last_name": "STOHR",
            "middle_name": "L.",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.