Individual provider Active NPI

Wesley Blank, CDCA

  • Behavior Technician
  • Maumee, OH
National Provider Identifier
1295533305
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
CDCA191070 Issued in OH
Practice address
1760 Manley Rd
Maumee, OH 43537-9400
Phone
(567) 249-9083
NPI assigned
Mar 4, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X CDCA191070 OH Primary

Addresses

Primary practice location

1760 Manley Rd
Maumee, OH 43537-9400

Mailing address

6128 Greenacre Rd
Toledo, OH 43615-1016

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
CDCA191070OHMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Detox Center LLC Past Accepting new patients
Valor Recovery Center of Youngstown LLC Past Accepting new patients
Valor Recovery Center of Youngstown LLC Past Accepting new patients
Midwest Detox Center LLC Past Accepting new patients
Midwest Recovery Center LLC Past Accepting new patients
Midwest Recovery Center LLC Past Accepting new patients

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1295533305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6128 GREENACRE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 MANLEY RD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435379400",
            "telephone_number": "567-249-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANK",
        "first_name": "WESLEY",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OH",
            "license": "CDCA191070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.