Individual provider Active NPI

Delores Veronica Sumter

  • Professional Counselor
  • Amelia, OH
National Provider Identifier
1376061465
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C.1300174 Issued in OH
Practice address
43 E Main St
Amelia, OH 45102-1993
Phone
(513) 947-7000
NPI assigned
Sep 8, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X C.1300174 OH Primary

Addresses

Primary practice location

43 E Main St
Amelia, OH 45102-1993

Mailing address

43 E Main St
Amelia, OH 45102-1993
Phone (513) 947-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231212001286 DC Practitioner - Mental Health Counselor 9638528995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1300174OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
Anchor Mental Health Association Single Specialty Current Accepting new patients

Locations

106 Irving St NW
Ste 4200
Washington, DC 20010
Phone (202) 877-2200

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3007 Tilden St NW
Ste 5N
Washington, DC 20008

Organizations & group practices 2

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": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376061465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 E MAIN ST",
            "city": "AMELIA",
            "state": "OH",
            "postal_code": "451021993",
            "telephone_number": "513-947-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 E MAIN ST",
            "city": "AMELIA",
            "state": "OH",
            "postal_code": "451021993",
            "telephone_number": "513-947-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMTER",
        "first_name": "DELORES",
        "middle_name": "VERONICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1300174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amelia, OH

Sources for this page

Verify at the official NPI Registry.