Individual provider Active NPI

Sydney Wilkerson

  • Addiction (Substance Use Disorder) Counselor
  • Milford, OH
National Provider Identifier
1144897299
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.187072 Issued in OH
Practice address
25 Whitney Dr
Milford, OH 45150-8402
Phone
(513) 941-4999
Fax
(513) 694-0168
NPI assigned
Jun 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.2304740-TRNE OH
Professional Counselor 101YP2500X C.2405945 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.187072 OH Primary

Addresses

Primary practice location

25 Whitney Dr
Milford, OH 45150-8402

Mailing address

6460 Harrison Ave Ste 200
Cincinnati, OH 45247-7958
Phone (513) 941-4999

Other identifiers 1

IdentifierTypeStateIssuer
0038440MedicaidOH

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.187072OHMDAddiction (Substance Use Disorder) Counselor
C.2304740-TRNEOHMDMental Health Counselor
C.2405945OHMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1144897299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6460 HARRISON AVE STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477958",
            "telephone_number": "513-941-4999",
            "fax_number": "513-694-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WHITNEY DR",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451508402",
            "telephone_number": "513-941-4999",
            "fax_number": "513-694-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKERSON",
        "first_name": "SYDNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2304740-TRNE",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2405945",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.187072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0038440",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.