Mary Bruce, LCDCIII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCDCIII.161773 Issued in NU

Practice address

425 Marion Pike
Coal Grove, OH 45638-2960

Phone

(740) 377-1998

NPI assigned

Nov 13, 2017

Last updated

Sep 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Life Recovery, LLC

  • Substance Abuse Rehabilitation Facility
  • Coal Grove, OH
  • NPI 1013543982
  NPD Authorized official
• New Life Recovery, LLC

  • Community/Behavioral Health Agency
  • Coal Grove, OH
  • NPI 1013793082
  NPD Authorized official

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1104339134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MARION PIKE",
            "city": "COAL GROVE",
            "state": "OH",
            "postal_code": "456382960",
            "telephone_number": "740-377-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MARION PIKE",
            "city": "COAL GROVE",
            "state": "OH",
            "postal_code": "456382960",
            "telephone_number": "740-377-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "MARY",
        "credential": "LCDCIII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCII.161421",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": "LCDCIII.161773",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Bowden, CDCA.167835
• Michal Bowling
• Sheila A Bowman
• Jeanette Boyd, CDCA.193964
• Danielle Boyer
• Carolyn Bryant, CDCA.188258
• David L Burney, CDCA.177160
• Randy Wayne Cable II, LISW, LICDC, PRS
• Riley Cade
• Daniel J Cardona, M.D.

• Addiction (Substance Use Disorder) Counselor in Coal Grove, OH
• Providers in Coal Grove, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.