Individual provider Active NPI

Stephen Kime

  • Addiction (Substance Use Disorder) Counselor
  • Toledo, OH
National Provider Identifier
1205328044
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.168753 Issued in OH
Practice address
4747 Monroe St
Toledo, OH 43623-4307
Phone
(419) 740-5709
NPI assigned
Jun 6, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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
Community/Behavioral Health Agency 251S00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.168753 OH Primary

Addresses

Primary practice location

4747 Monroe St
Toledo, OH 43623-4307

Mailing address

8656 Big Cypress Cir
Sylvania, OH 43560-8916

Other practice location 1

5726 Southwyck Blvd Ste 200
Toledo, OH 43614-1510
Phone (419) 865-5690

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.168753OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1205328044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8656 BIG CYPRESS CIR",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435608916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 MONROE ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234307",
            "telephone_number": "419-740-5709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5726 Southwyck Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436141510",
            "country_code": "US",
            "telephone_number": "419-865-5690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIME",
        "first_name": "STEPHEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.168753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 23, 2021; 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.