Active NPI
Tiffany Nicole Wells
- Addiction (Substance Use Disorder) Counselor
- Kettering, OH
National Provider Identifier
1235915331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.185529
- Practice address
- 2632 Woodman Center CT
Kettering, OH 45420-1477 - Phone
- (937) 739-7100
- Fax
- (480) 687-7361
- NPI assigned
- Sep 5, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | CDCA.185529 | OH | Primary |
Addresses
Primary practice location
2632 Woodman Center CT
Kettering, OH 45420-1477
Mailing address
8444 N 90TH St Ste 100
Scottsdale, AZ 85258-4437
Phone (480) 977-1438
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 |
|---|---|---|---|
| CDCA.185529 | 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": "1693872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693872000000",
"number": "1235915331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8444 N 90TH ST STE 100",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852584437",
"telephone_number": "480-977-1438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2632 WOODMAN CENTER CT",
"city": "KETTERING",
"state": "OH",
"postal_code": "454201477",
"telephone_number": "937-739-7100",
"fax_number": "480-687-7361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "TIFFANY",
"middle_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-05",
"last_updated": "2023-09-05",
"certification_date": "2023-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.185529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kettering, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.