Thomas Dillingham Jr., LICDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

161408 Issued in OH

Practice address

4421 Roosevelt Blvd Ste a
Middletown, OH 45044-9024

Phone

(833) 952-0829

NPI assigned

Dec 27, 2016

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1482796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564531200000",
    "number": "1225573496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291943",
            "address_2": "525 ROYAL PARKWAY",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372291943",
            "telephone_number": "833-953-0829",
            "fax_number": "833-952-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 ROOSEVELT BLVD STE A",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450449024",
            "telephone_number": "833-952-0829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5108 Sandy Ln",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "OH",
            "postal_code": "450142738",
            "country_code": "US",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DILLINGHAM",
        "first_name": "THOMAS",
        "name_suffix": "Jr.",
        "credential": "LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-27",
        "last_updated": "2019-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "161408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0246686",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gagandeep Dhaliwal, PMHNP
• Roxanne Dickenson
• Robert Dickey, CRNA
• Steffani Diesel-Slone, PSY. S.
• Madison Kate Dietz, OTR/L
• Melissa Marie Dinsmore, RN, CCNS
• Adrianne S Dirr, OD
• Angela Dawn Diver, LISW, LICDC
• Brianna Domineck
• Emanuel Carlo Donaldson

• Addiction (Substance Use Disorder) Counselor in Middletown, OH
• Providers in Middletown, 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 Jul 31, 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.