Individual provider Active NPI

Nathan Pubentz

  • Addiction (Substance Use Disorder) Counselor
  • Cincinnati, OH
National Provider Identifier
1285012088
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LICDC.161377 Issued in OH
Practice address
3009 Burnet Ave
Cincinnati, OH 45219-2419
Phone
(513) 751-7747
NPI assigned
May 12, 2015
Last updated
Jul 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.161377 OH Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.110371 OH
Social Worker 104100000X S.1400321-TRNE OH

Addresses

Primary practice location

3009 Burnet Ave
Cincinnati, OH 45219-2419

Mailing address

2600 Victory Pkwy
Cincinnati, OH 45206-1395
Phone (513) 751-7747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240113000173 OH Practitioner - Clinical Social Worker 5395197495 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CDCA.110371OHMDAddiction (Substance Use Disorder) Counselor
LICDC.161377OHMDAddiction (Substance Use Disorder) Counselor
S.1400321-TRNEOHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Talbert House CurrentSince Jan 1, 2024 Accepting new patients

Locations

1515 Carll St
Cincinnati, OH 45225
Phone (513) 244-3985

2600 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 872-5863

2602 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 221-4673

3009 Burnet Ave
Cincinnati, OH 45219
Phone (513) 242-7164

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1285012088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 VICTORY PKWY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061395",
            "telephone_number": "513-751-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 BURNET AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192419",
            "telephone_number": "513-751-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUBENTZ",
        "first_name": "NATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161377",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.110371",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1400321-TRNE",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.