Individual provider Active NPI

Raymond Wang, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Hamilton, OH
National Provider Identifier
1134625445
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.168751 Issued in OH
Practice address
621 S. Erie Blvd
Hamilton, OH 45011
Phone
(513) 868-0055
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.168751 OH Primary

Addresses

Primary practice location

621 S. Erie Blvd
Hamilton, OH 45011

Mailing address

446 Morgan St
Cincinnati, OH 45206-2348
Phone (513) 834-7063

Other practice location 1

5108 Sandy Ln
Fairfield, OH 45014-2738
Phone (513) 834-7063

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.168751OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1134625445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 MORGAN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452062348",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S. ERIE BLVD",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "45011",
            "telephone_number": "513-868-0055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5108 Sandy Ln",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "OH",
            "postal_code": "450142738",
            "country_code": "US",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "RAYMOND",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.168751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.