Individual provider Active NPI

Heather Wasserman, BA, CT

  • Mental Health Counselor
  • Beavercreek, OH
National Provider Identifier
1184395501
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.2204269-TRNE Issued in OH
Practice address
1411 N Fairfield Rd
Beavercreek, OH 45432-2637
Phone
(937) 426-2686
NPI assigned
Sep 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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.2204269-TRNE OH Primary
Counselor 101Y00000X C.2204269-TRNE OH
Behavior Technician 106S00000X RBT-19-104392 OH

Addresses

Primary practice location

1411 N Fairfield Rd
Beavercreek, OH 45432-2637

Mailing address

3095 Kettering Blvd
Moraine, OH 45439-1983
Phone (937) 293-8300

Other practice location 1

3095 Kettering Blvd
Moraine, OH 45439-1983
Phone (937) 534-1572

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
C.2204269-TRNEOHMDMental Health Counselor
RBT-19-104392OHMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1184395501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391983",
            "telephone_number": "937-293-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N FAIRFIELD RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322637",
            "telephone_number": "937-426-2686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3095 Kettering Blvd",
            "address_purpose": "LOCATION",
            "city": "Moraine",
            "state": "OH",
            "postal_code": "454391983",
            "country_code": "US",
            "telephone_number": "937-534-1572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "HEATHER",
        "credential": "BA, CT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-24",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2204269-TRNE",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.2204269-TRNE",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OH",
            "license": "RBT-19-104392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.