Active NPI
David J McWilliams, CDCA
- Addiction (Substance Use Disorder) Counselor
- Warren, OH
National Provider Identifier
1093581969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.186403
- Practice address
- 1212 Tod PL NW
Warren, OH 44485-2475 - Phone
- (330) 469-6822
- Fax
- (330) 294-5641
- NPI assigned
- Nov 30, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.186403 | OH | Primary |
Addresses
Primary practice location
1212 Tod PL NW
Warren, OH 44485-2475
Mailing address
1212 Tod PL NW
Warren, OH 44485-2475
Phone (330) 469-6822
Other practice location 1
2430 Parkman Rd NW
Warren, OH 44485-1777
Phone (330) 469-6822
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
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.186403 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safe Harbor Recovery, LLC | Current | Accepting new patients | |
| FSR of Parkman LLC | Past | Accepting new patients |
Locations
1212 Tod Pl NW
Warren, OH 44485
Phone (330) 469-6822
2430 Parkman Rd NW
Warren, OH 44485
Phone (330) 469-6822
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/parkmanrecovery/r4/
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.
-
- Substance Abuse Rehabilitation Facility
- Warren, OH
- NPI 1437771870
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Warren, OH
- NPI 1487168084
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1093581969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 TOD PL NW",
"city": "WARREN",
"state": "OH",
"postal_code": "444852475",
"telephone_number": "330-469-6822",
"fax_number": "330-294-5641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 TOD PL NW",
"city": "WARREN",
"state": "OH",
"postal_code": "444852475",
"telephone_number": "330-469-6822",
"fax_number": "330-294-5641"
}
],
"practiceLocations": [
{
"address_1": "2430 Parkman Rd NW",
"address_purpose": "LOCATION",
"city": "Warren",
"state": "OH",
"postal_code": "444851777",
"country_code": "US",
"telephone_number": "330-469-6822",
"fax_number": "330-294-5641",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCWILLIAMS",
"first_name": "DAVID",
"middle_name": "J",
"credential": "CDCA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-11-30",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.186403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Warren, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.