Active NPI
Myrtle Boykin-Lighton
- Addiction (Substance Use Disorder) Counselor
- Lima, OH
National Provider Identifier
1265815591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1163
- Practice address
- 809 W Vine St
Lima, OH 45804-1054 - Phone
- (419) 222-4474
- Fax
- (419) 222-7044
- NPI assigned
- Jul 6, 2015
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | OH | ||
| Clinical Laboratory Director (Non-physician) | 247ZC0005X | OH | ||
| Prevention Professional | 405300000X | 0782 | OH | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1163 | OH | Primary |
Addresses
Primary practice location
809 W Vine St
Lima, OH 45804-1054
Mailing address
809 W Vine St
Lima, OH 45804-1054
Phone (419) 222-4474
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 341741132 | Medicaid | OH |
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 |
|---|---|---|---|
| 1163 | OH | MD | Chiropractor |
| 0782 | OH | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503360000000",
"number": "1265815591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 W VINE ST",
"city": "LIMA",
"state": "OH",
"postal_code": "458041054",
"telephone_number": "419-222-4474",
"fax_number": "419-222-7044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 W VINE ST",
"city": "LIMA",
"state": "OH",
"postal_code": "458041054",
"telephone_number": "419-222-4474",
"fax_number": "419-222-7044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYKIN-LIGHTON",
"first_name": "MYRTLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-06",
"last_updated": "2017-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "247ZC0005X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "OH",
"license": "0782",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "1163",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "341741132",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lima, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.