Individual provider Active NPI

Samantha Berberich, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Dayton, OH
National Provider Identifier
1295404242
Registry record updated Sep 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
177588 Issued in OH
Practice address
1 Elizabeth PL
Dayton, OH 45417-3445
Phone
(937) 813-1737
NPI assigned
Sep 12, 2021
Last updated
Sep 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 177588 OH Primary

Addresses

Primary practice location

1 Elizabeth PL
Dayton, OH 45417-3445

Mailing address

230 N 2ND St
Tipp City, OH 45371-1910
Phone (740) 463-1020

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

LicenseStateTypeSpecialty
177588OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1631404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631404800000",
    "number": "1295404242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N 2ND ST",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453711910",
            "telephone_number": "740-463-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173445",
            "telephone_number": "937-813-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERBERICH",
        "first_name": "SAMANTHA",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-12",
        "last_updated": "2021-09-12",
        "certification_date": "2021-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "177588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2021; 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.