Active NPI
Staci Mitchell
- Addiction (Substance Use Disorder) Counselor
- Toledo, OH
National Provider Identifier
1356949044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 172856
- Practice address
- 4747 Monroe St
Toledo, OH 43623-4307 - Phone
- (833) 440-8640
- NPI assigned
- Oct 14, 2020
- Sex
- Female
- 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 | 172856 | OH | Primary |
Addresses
Primary practice location
4747 Monroe St
Toledo, OH 43623-4307
Mailing address
4747 Monroe St
Toledo, OH 43623-4307
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 |
|---|---|---|---|
| 172856 | 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": "1602633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1356949044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4747 MONROE ST",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436234307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4747 MONROE ST",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436234307",
"telephone_number": "833-440-8640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "STACI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-14",
"last_updated": "2020-10-14",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "172856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.