Active NPI
Laura Mae Squibbs
- Addiction (Substance Use Disorder) Counselor
- Youngstown, OH
National Provider Identifier
1154929271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 172253
- Practice address
- 1319 Florencedale Ave
Youngstown, OH 44505-2719 - Phone
- (330) 743-4673
- Fax
- (330) 743-1073
- NPI assigned
- Oct 12, 2020
- 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 | 172253 | OH | Primary |
Addresses
Primary practice location
1319 Florencedale Ave
Youngstown, OH 44505-2719
Mailing address
2174 Niles Cortland Road North East
Cortland, OH 44410-2719
Phone (330) 360-6399
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 |
|---|---|---|---|
| 172253 | 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": "1602460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602460800000",
"number": "1154929271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2174 NILES CORTLAND ROAD NORTH EAST",
"city": "CORTLAND",
"state": "OH",
"postal_code": "444102719",
"telephone_number": "330-360-6399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1319 FLORENCEDALE AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445052719",
"telephone_number": "330-743-4673",
"fax_number": "330-743-1073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SQUIBBS",
"first_name": "LAURA",
"middle_name": "MAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-12",
"last_updated": "2020-10-12",
"certification_date": "2020-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "172253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.