NPIMap

Individual provider Active NPI

Mindy Dennis, LICDC/LPC

  • Addiction (Substance Use Disorder) Counselor
  • Newark, OH
National Provider Identifier
1366180952
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LICDC.162629 Issued in OH
Practice address
974 N 21St St
Newark, OH 43055-2990
Phone
(833) 510-4357
NPI assigned
May 24, 2022
Last updated
May 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.162629 OH Primary
Professional Counselor 101YP2500X C.2304955 OH

Addresses

Primary practice location

974 N 21St St
Newark, OH 43055-2990

Mailing address

4600 Montgomery Rd Ste 400
Cincinnati, OH 45212-2600
Phone (833) 510-4357

Other practice location 1

2065 Stoneridge Dr
Circleville, OH 43113-8956
Phone (740) 500-1391

Other names 1

  • Mindy Campbell Former name

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
LICDC.162629OHMDAddiction (Substance Use Disorder) Counselor
C.2304955OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Recovery of Circleville CurrentSince May 1, 2022 Accepting new patients
Full Circle Recovery of Circleville CurrentSince May 1, 2022 Accepting new patients
Brightview, LLC Past Accepting new patients

Locations

2065 Stoneridge Dr
Circleville, OH 43113
Phone (740) 500-1391

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/hopevalleyrecovery/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1366180952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MONTGOMERY RD STE 400",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452122600",
            "telephone_number": "833-510-4357"
        },
        {
            "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": "833-510-4357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2065 Stoneridge Dr",
            "address_purpose": "LOCATION",
            "city": "Circleville",
            "state": "OH",
            "postal_code": "431138956",
            "country_code": "US",
            "telephone_number": "740-500-1391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "MINDY",
        "credential": "LICDC/LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162629",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2304955",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINDY",
            "last_name": "CAMPBELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 May 16, 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.

Verify at the official NPI Registry.