NPIMap

Organization Active NPI

Shalom Ministries

Doing business as Shalom Counseling & Mediation Center

  • Community/Behavioral Health Agency
  • Archbold, OH
National Provider Identifier
1366573552
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
I8483 Issued in OH
Legal business name
SHALOM MINISTRIES
Doing business as
Shalom Counseling & Mediation Center
Practice address
22251 State Route 2
Archbold, OH 43502-9452
Phone
(419) 445-1552
Fax
(419) 445-1401
NPI assigned
Mar 8, 2007
Last updated
Jun 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Authorized official

Name
Jessica BittnerNPI 1194237099
Title
Executive Director
Phone
(419) 445-1552

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X I8483 OH Primary

Addresses

Primary practice location

22251 State Route 2
Archbold, OH 43502-9452

Mailing address

22251 State Route 2
Archbold, OH 43502-9452
Phone (419) 445-1552

Other practice location 1

5030 County Road 15 Ste C
Bryan, OH 43506-9767
Phone (419) 636-1713

Other practice location 2

400 Enterprise Ave
Wauseon, OH 43567-9330
Phone (419) 330-3522

Other identifiers 2

IdentifierTypeStateIssuer
11648876OtherCAQH PROVIDER ID
0423177MedicaidOH

Other names 2

  • Shalom Counseling & Mediation Center Doing business as
  • Shalom Ministries Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221213001281 OH Part B Supplier - Clinic/Group Practice 7911376033 Receives reassigned benefits from 16 practitioners
Practice locations: Archbold, OH; Bryan, OH; Wauseon, OH

National Provider Directory

National Provider Directory

Locations

22251 State Route 2
Archbold, OH 43502
Phone (419) 445-1552

5030 County Road 15
#C
Bryan, OH 43506
Phone (419) 636-1713

400 Enterprise Ave
Wauseon, OH 43567
Phone (419) 330-3522

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748908800000",
    "number": "1366573552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22251 STATE ROUTE 2",
            "city": "ARCHBOLD",
            "state": "OH",
            "postal_code": "435029452",
            "telephone_number": "419-445-1552",
            "fax_number": "419-445-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22251 STATE ROUTE 2",
            "city": "ARCHBOLD",
            "state": "OH",
            "postal_code": "435029452",
            "telephone_number": "419-445-1552",
            "fax_number": "419-445-1401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5030 County Road 15 Ste C",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "OH",
            "postal_code": "435069767",
            "country_code": "US",
            "telephone_number": "419-636-1713",
            "fax_number": "419-445-1401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Enterprise Ave",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "435679330",
            "country_code": "US",
            "telephone_number": "419-330-3522",
            "fax_number": "419-445-1401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHALOM MINISTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A",
        "authorized_official_last_name": "BITTNER",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "419-445-1552"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "I8483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11648876",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0423177",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shalom Counseling & Mediation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shalom Counseling & Mediation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shalom Ministries",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shalom Ministries",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Archbold, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.