Active NPI
Thomas Johnson, LICDC-CS
- Addiction (Substance Use Disorder) Counselor
- Newark, OH
National Provider Identifier
1346777141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LICDC.852156
- Practice address
- 974 N 21St St
Newark, OH 43055-2990 - Phone
- (513) 834-7063
- NPI assigned
- May 11, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2053 | DE | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LICDC.852156 | OH | Primary |
Addresses
Primary practice location
974 N 21St St
Newark, OH 43055-2990
Mailing address
615 Elsinore PL Ste 200
Cincinnati, OH 45202-1457
Phone (513) 834-7063
Other practice location 1
825 Dennison Ave
Columbus, OH 43215-1315
Phone (614) 276-4840
Other practice location 2
501 W Market St
Ste 105
Georgetown, DE 19947-1994
Phone (833) 510-4357
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 |
|---|---|---|---|
| 2053 | DE | MD | Addiction (Substance Use Disorder) Counselor |
| LICDC.852156 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671667200000",
"number": "1346777141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 ELSINORE PL STE 200",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452021457",
"telephone_number": "513-834-7063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "974 N 21ST ST",
"city": "NEWARK",
"state": "OH",
"postal_code": "430552990",
"telephone_number": "513-834-7063"
}
],
"practiceLocations": [
{
"address_1": "825 Dennison Ave",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432151315",
"country_code": "US",
"telephone_number": "614-276-4840",
"fax_number": "614-276-4746",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "501 W Market St",
"address_2": "Ste 105",
"address_purpose": "LOCATION",
"city": "Georgetown",
"state": "DE",
"postal_code": "199471994",
"country_code": "US",
"telephone_number": "833-510-4357",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "THOMAS",
"credential": "LICDC-CS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-11",
"last_updated": "2022-12-22",
"certification_date": "2022-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "DE",
"license": "2053",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "LICDC.852156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.