NPIMap

Individual provider Active NPI

Karen A. Byrd, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Toledo, OH
National Provider Identifier
1154820975
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.150801 Issued in OH
Practice address
115 S Reynolds Rd
Toledo, OH 43615
Phone
(419) 725-6631
NPI assigned
Feb 7, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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 CDCA.150801 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.150801 OH Primary

Addresses

Primary practice location

115 S Reynolds Rd
Toledo, OH 43615

Mailing address

115 S Reynolds Rd
Toledo, OH 43615-6958
Phone (419) 725-6631

Other practice location 1

5164 Monroe St
Toledo, OH 43623
Phone (419) 720-9586

Other practice location 2

5164 Monroe St
Toledo, OH 43623
Phone (419) 720-9586

Other identifiers 1

IdentifierTypeStateIssuer
0286402MedicaidOH

Other names 1

  • Karen A. Ricketts Former name

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.150801OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A Renewed Mind Past Accepting new patients
Brain Bright Therapy LLC PastSince Jun 1, 2017 Accepting new patients
Pinnacle Treatment Centers Oh-IX, LLC PastSince Sep 25, 2019 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1154820975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S REYNOLDS RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436156958",
            "telephone_number": "419-725-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S REYNOLDS RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43615",
            "telephone_number": "419-725-6631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5164 Monroe St",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "43623",
            "country_code": "US",
            "telephone_number": "419-720-9586",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5164 Monroe St",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "43623",
            "country_code": "US",
            "telephone_number": "419-720-9586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYRD",
        "first_name": "KAREN",
        "middle_name": "A.",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-07",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": "CDCA.150801",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.150801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0286402",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "RICKETTS",
            "middle_name": "A.",
            "credential": "CDCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Sep 18, 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.