Directly Affected LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

DIRECTLY AFFECTED LLC

Practice address

1206 Waller Street
Portsmouth, OH 45662

Phone

(614) 980-2116

NPI assigned

Nov 22, 2022

Organization subpart

No

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

Authorized official

Name

Dominique Myrick

Title

Owner

Phone

(614) 980-2116

Specialties & licenses 1

Addresses

Tax ID family

Directly Affected LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Directly Affected LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Portsmouth, OH
  • NPI 1144939588
  NPD tax ID

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1396454047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 S TERRIPIN",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852094959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 WALLER STREET",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "45662",
            "telephone_number": "614-980-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECTLY AFFECTED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "MYRICK",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-980-2116"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Khoury Dibiagio, DNP, AGAC-NP
• Rita Dietrich
• Corrina Dillenger, LPN
• Emma E Dillow, LSW
• Directly Affected LLC
• John Francis Ditraglia, MD
• Andrew James Dittenhofer, D.O
• Seth Dixon, CMS
• Sherry Dixon
• John William Dobson, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.