Active NPI
Angeletta L Fair
- Addiction (Substance Use Disorder) Counselor
- Columbus, OH
National Provider Identifier
1154062487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.180148
- Practice address
- 813 Bryden Rd
Columbus, OH 43205-1759 - Phone
- (614) 392-7253
- NPI assigned
- Apr 1, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.180148 | OH | Primary |
Addresses
Primary practice location
813 Bryden Rd
Columbus, OH 43205-1759
Mailing address
6161 Busch Blvd Ste 290
Columbus, OH 43229-2587
Phone (614) 987-5003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 474422489 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.180148 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1154062487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6161 BUSCH BLVD STE 290",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432292587",
"telephone_number": "614-987-5003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 BRYDEN RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432051759",
"telephone_number": "614-392-7253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIR",
"first_name": "ANGELETTA",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-01",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.180148",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "474422489",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.