Individual provider Active NPI

Melodie L Hernandez, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Lebanon, OH
National Provider Identifier
1104317486
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
188168 Issued in OH
Practice address
1521 Walmart Dr Ste 901
Lebanon, OH 45036-8359
Phone
(513) 225-7736
NPI assigned
May 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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) Counselor 101YA0400X 188168 OH Primary

Addresses

Primary practice location

1521 Walmart Dr Ste 901
Lebanon, OH 45036-8359

Mailing address

3501 W State Route 22 3 Apt 3
Loveland, OH 45140-3508
Phone (513) 225-7736

Other practice location 1

3501 W State Route 22 3 Apt 3
Loveland, OH 45140-3508
Phone (513) 225-7736

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
188168OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Orange Care of Miami In Home Supportive Care Past Accepting new patients
Orange Care of Miami In Home Supportive Care 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.

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1104317486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 W STATE ROUTE 22 3 APT 3",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451403508",
            "telephone_number": "513-225-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 WALMART DR STE 901",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450368359",
            "telephone_number": "513-225-7736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 W State Route 22 3 Apt 3",
            "address_purpose": "LOCATION",
            "city": "Loveland",
            "state": "OH",
            "postal_code": "451403508",
            "country_code": "US",
            "telephone_number": "513-225-7736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MELODIE",
        "middle_name": "L",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "188168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.

Verify at the official NPI Registry.