Marisa M Badgley, MS, LPCC-S , LICDC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.1200246 Issued in OH

Practice address

5335 Far Hills Ave Ste 211
Dayton, OH 45429-2317

Phone

(937) 221-8434

NPI assigned

Sep 26, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1134555840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5335 FAR HILLS AVE STE 211",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292317",
            "telephone_number": "937-221-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5335 FAR HILLS AVE STE 211",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292317",
            "telephone_number": "937-221-8434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "759 Columbus Ave",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OH",
            "postal_code": "450361754",
            "country_code": "US",
            "telephone_number": "513-932-4337",
            "fax_number": "513-751-0180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BADGLEY",
        "first_name": "MARISA",
        "middle_name": "M",
        "credential": "MS, LPCC-S , LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-26",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "151092",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1200246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0226088",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Logan Bacon, DO
• John B Badcock, DO
• Kyrie Eleyson R Baden, PHARMD
• M Catherine Bader
• Michael Badger, CASE MANAGER
• Kayla Badnell
• Namsu Bae
• Husani G.a. Bagamba, LPC
• Laura K Baggette, MT-BC
• Alex Michael Bagwell

• Professional Counselor in Dayton, OH
• Providers in Dayton, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.