Individual provider Active NPI

Edward Fitch, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Ontario, OH
National Provider Identifier
1104701192
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.193171 Issued in OH
Practice address
2281 Village Mall Dr Unit 3
Ontario, OH 44906-1153
Phone
(904) 755-4997
NPI assigned
Aug 8, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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 CDCA.193171 OH Primary

Addresses

Primary practice location

2281 Village Mall Dr Unit 3
Ontario, OH 44906-1153

Mailing address

2281 Village Mall Dr Unit 3
Ontario, OH 44906-1153
Phone (904) 755-4997

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
CDCA.193171OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Redemption Recovery Group LLC CurrentSince Aug 10, 2025 Accepting new patients
Redemption Recovery Group LLC CurrentSince Aug 10, 2025 Accepting new patients

Locations

2281 Village Mall Dr
Unit 3
Ontario, OH 44906
Phone (772) 353-1410

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": "1754611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1104701192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2281 VILLAGE MALL DR UNIT 3",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449061153",
            "telephone_number": "904-755-4997",
            "fax_number": "904-755-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2281 VILLAGE MALL DR UNIT 3",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449061153",
            "telephone_number": "904-755-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITCH",
        "first_name": "EDWARD",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-08",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.193171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.