Individual provider Active NPI

Sheronda Daugherty, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Toledo, OH
National Provider Identifier
1114732781
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.191307 Issued in OH
Practice address
2345 Dorr St
Toledo, OH 43607-3423
Phone
(419) 407-5342
Fax
(419) 407-5371
NPI assigned
Feb 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X QMHS OH
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.191307 OH Primary

Addresses

Primary practice location

2345 Dorr St
Toledo, OH 43607-3423

Mailing address

2345 Dorr St
Toledo, OH 43607-3423
Phone (419) 407-5342

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.191307OHMDAddiction (Substance Use Disorder) Counselor
QMHSOHMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1114732781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 DORR ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436073423",
            "telephone_number": "419-407-5342",
            "fax_number": "419-407-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 DORR ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436073423",
            "telephone_number": "419-407-5342",
            "fax_number": "419-407-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "SHERONDA",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": "QMHS",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.191307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.