Traci Demattia-Toth, LICDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LICDC.121139 Issued in OH

Practice address

7232 Justin Way
Mentor, OH 44060-4881

Phone

(440) 578-8200

NPI assigned

Oct 5, 2016

Last updated

Oct 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Signature Health, Inc.

  • Mental Health Counselor
  • Garfield Heights, OH
  • NPI 1679767289
  Medicare reassignment NPD
• Signature Health Inc

  dba Signature Health

  • Long Term Care Pharmacy
  • Willoughby, OH
  • NPI 1740502335
  NPD
• Signature Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Willoughby, OH
  • NPI 1477575348
  NPD

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633737600000",
    "number": "1184174922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7232 JUSTIN WAY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604881",
            "telephone_number": "440-578-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7232 JUSTIN WAY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604881",
            "telephone_number": "440-578-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMATTIA-TOTH",
        "first_name": "TRACI",
        "credential": "LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2021-10-09",
        "certification_date": "2021-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.121139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0187798",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Ryan Delasos, DO
• Emily K Delimpo, PT
• Greg Delluomo, PHARMD
• Pamela L Delotelle, QMHS
• Jennifer Lynn Demarco
• Lisa Demeter, LISW-S
• Cassandra N Demeza, LSW
• Dental Group of Mentor
• Dental Group of Mentor, Jeffrey S. Rosenthal, DDS, Inc
• Dental Professionals Cleveland-Nouneh, Inc. (brightnow dental)

• Addiction (Substance Use Disorder) Counselor in Mentor, OH
• Providers in Mentor, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.