Bambi Suzanne Hendrix, CPRS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

0002786 Issued in OH

Practice address

104 Spink St
Wooster, OH 44691-3652

Phone

(330) 264-8498

Fax

(330) 264-3777

NPI assigned

Apr 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 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": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1285217299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 PARKVIEW DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912730",
            "telephone_number": "330-201-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SPINK ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913652",
            "telephone_number": "330-264-8498",
            "fax_number": "330-264-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "BAMBI",
        "middle_name": "SUZANNE",
        "credential": "CPRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2022-02-02",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "176461",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "0002786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hendrixb@one-eighty.org",
            "affiliation": "N",
            "address_1": "104 Spink St",
            "city": "Wooster",
            "state": "OH",
            "country_code": "US",
            "postal_code": "446913652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dennis Helmuth, MD
• Kathryn O Helmuth, M.D.
• Erica Kaye Hemming
• Aundrey J Hendershot
• Ashley Henderson
• Nathanael Anthony Hendrix, LMSW
• Miranda Hendrus, AUDIOLOGIST
• Brianna Lee Henley
• Tiffany Henline, QMHS
• Lilly Elizabeth Henney

• Peer Specialist in Wooster, OH
• Providers in Wooster, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; 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.