Individual provider Active NPI

Nazaria Shakayia Dismuke

  • Addiction (Substance Use Disorder) Counselor
  • Columbus, OH
National Provider Identifier
1386484954
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.192001 Issued in OH
Practice address
211 S 5TH St
Columbus, OH 43215-5203
Phone
(614) 567-6274
NPI assigned
May 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X CDCA.192001 OH Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Case Manager/Care Coordinator 171M00000X 171M000000X OH

Addresses

Primary practice location

211 S 5TH St
Columbus, OH 43215-5203

Mailing address

211 S 5TH St
Columbus, OH 43215-5203
Phone (614) 567-6274

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
CDCA.192001OHMDAddiction (Substance Use Disorder) Counselor
171M000000XOHMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Forward Health LLC Mental Health (Including Community Mental Health Center) CurrentSince Nov 9, 2025 Accepting new patients
Forward Health LLC CurrentSince Nov 9, 2025 Accepting new patients

Locations

200 E Rich St
Columbus, OH 43215
Phone (614) 567-6274

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1386484954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S 5TH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155203",
            "telephone_number": "614-567-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S 5TH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155203",
            "telephone_number": "614-567-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISMUKE",
        "first_name": "NAZARIA",
        "middle_name": "SHAKAYIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-30",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.192001",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": "171M000000X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.