Individual provider Active NPI

Bryn Oldham, LPCC-S

  • Professional Counselor
  • Kent, OH
National Provider Identifier
1306084199
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0700272 Issued in OH
Practice address
1268 Greenwood Ave
Kent, OH 44240-6306
Phone
(330) 274-6238
NPI assigned
Feb 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 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
Professional Counselor 101YP2500X C0700272 OH
Professional Counselor 101YP2500X 0700272 OH Primary

Addresses

Primary practice location

1268 Greenwood Ave
Kent, OH 44240-6306

Mailing address

1268 Greenwood Ave
Kent, OH 44240-6306
Phone (330) 274-6238

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
0700272OHMDProfessional Counselor
C0700272OHMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1306084199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 GREENWOOD AVE",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442406306",
            "telephone_number": "330-274-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 GREENWOOD AVE",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442406306",
            "telephone_number": "330-274-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "BRYN",
        "name_prefix": "Mrs.",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-02",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C0700272",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "0700272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.