Individual provider Active NPI

Julia Marie Light, CDCA

  • Mental Health Counselor
  • Wooster, OH
National Provider Identifier
1114519303
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CDCA.175907 Issued in OH
Practice address
104 Spink St
Wooster, OH 44691-3652
Phone
(330) 264-8498
Fax
(330) 264-3777
NPI assigned
Feb 9, 2021
Last updated
Feb 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CDCA.175907 OH Primary

Addresses

Primary practice location

104 Spink St
Wooster, OH 44691-3652

Mailing address

80 S 2ND St
Rittman, OH 44270-1443
Phone (330) 760-9315

Other names 1

  • Mrs. Julia Marie Light Professional name

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.175907OHMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1114519303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 S 2ND ST",
            "city": "RITTMAN",
            "state": "OH",
            "postal_code": "442701443",
            "telephone_number": "330-760-9315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SPINK ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913652",
            "telephone_number": "330-264-8498",
            "fax_number": "330-264-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "JULIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "CDCA.175907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIA",
            "last_name": "LIGHT",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "CDCA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.