Active NPI
Joel A McCleary, MS, MED
- Addiction (Substance Use Disorder) Counselor
- South Bend, IN
National Provider Identifier
1346632957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- C2-1963
- Practice address
- 17815 Woodthrush LN
South Bend, IN 46635-1329 - Phone
- (402) 770-0464
- NPI assigned
- Feb 19, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | C2-1963 | IN | Primary |
Addresses
Primary practice location
17815 Woodthrush LN
South Bend, IN 46635-1329
Mailing address
17815 Woodthrush LN
South Bend, IN 46635-1329
Phone (402) 770-0464
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
- Credentials
- Master of Education, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C2-1963 | IN | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424304000000",
"number": "1346632957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17815 WOODTHRUSH LN",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351329",
"telephone_number": "402-770-0464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17815 WOODTHRUSH LN",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351329",
"telephone_number": "402-770-0464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLEARY",
"first_name": "JOEL",
"middle_name": "A",
"credential": "MS, MED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-19",
"last_updated": "2015-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IN",
"license": "C2-1963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.