Stephanie Lynn Canterbury, CADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

2-01594 Issued in MI

Practice address

1071 Tong Hollow Rd
Bainbridge, OH 45612-1500

Phone

(740) 634-3094

NPI assigned

May 14, 2018

Last updated

Jan 7, 2020By 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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/lys/r4/

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.

• Lighthouse Youth Services Inc.

  dba Lighthouse Youth & Family Services

  • Addiction (Substance Use Disorder) Counselor
  • Bainbridge, OH
  • NPI 1053389841
  NPD (past)

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1114417334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25762 BRIDGEWOOD LN APT 52",
            "city": "BROWNSTOWN",
            "state": "MI",
            "postal_code": "481341040",
            "telephone_number": "740-336-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1071 TONG HOLLOW RD",
            "city": "BAINBRIDGE",
            "state": "OH",
            "postal_code": "456121500",
            "telephone_number": "740-634-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTERBURY",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII.161537",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "2-01594",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hunter Anthony Brown
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• William C Bryant, CDCA
• Gregory Paul Bushatz, QMHS, CDCA
• Tara Campbell, LPC, LCDCIII
• Rusty Captain
• Carehere LLC
• Austin Chester
• Mason Reed Clifford
• Rick Cline, QMHS

• Addiction (Substance Use Disorder) Counselor in Bainbridge, OH
• Providers in Bainbridge, 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 Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.