Active NPI
Ashley Suzette Keith
- Addiction (Substance Use Disorder) Counselor
- Fairborn, OH
National Provider Identifier
1346045689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 191589
- Practice address
- 1428 N Broad St Apt 3
Fairborn, OH 45324-5567 - Phone
- (937) 986-8904
- NPI assigned
- Feb 19, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 191589 | OH | Primary |
Addresses
Primary practice location
1428 N Broad St Apt 3
Fairborn, OH 45324-5567
Mailing address
1428 N Broad St Apt 3
Fairborn, OH 45324-5567
Phone (937) 986-8904
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
| License | State | Type | Specialty |
|---|---|---|---|
| 191589 | OH | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emerge Recovery and Trades Initiative | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Xenia, OH
- NPI 1205544426
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751328000000",
"number": "1346045689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1428 N BROAD ST APT 3",
"city": "FAIRBORN",
"state": "OH",
"postal_code": "453245567",
"telephone_number": "937-986-8904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1428 N BROAD ST APT 3",
"city": "FAIRBORN",
"state": "OH",
"postal_code": "453245567",
"telephone_number": "937-986-8904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEITH",
"first_name": "ASHLEY",
"middle_name": "SUZETTE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-19",
"last_updated": "2025-07-01",
"certification_date": "2025-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "191589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairborn, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.