Active NPI
Eric D McLellan, LPCC
- Mental Health Counselor
- Kettering, OH
National Provider Identifier
1417047630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E3231
- Practice address
- 1948 E Whipp Rd Ste A2
Kettering, OH 45440-4239 - Phone
- (937) 643-0091
- Fax
- (866) 409-5783
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | E3231 | OH | |
| Mental Health Counselor | 101YM0800X | E3231 | OH | Primary |
Addresses
Primary practice location
1948 E Whipp Rd Ste A2
Kettering, OH 45440-4239
Mailing address
1948 E Whipp Rd Ste A2
Kettering, OH 45440-4239
Phone (937) 643-0091
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19432000 | Other | OH | MAGELLAN |
| 165435 | Other | OH | COMPSYCH |
| 6280674 | Other | OH | UBH |
| 947770 | Other | OH | CIGNA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| E3231 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411084800000",
"number": "1417047630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1948 E WHIPP RD STE A2",
"city": "KETTERING",
"state": "OH",
"postal_code": "454404239",
"telephone_number": "937-643-0091",
"fax_number": "866-409-5783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1948 E WHIPP RD STE A2",
"city": "KETTERING",
"state": "OH",
"postal_code": "454404239",
"telephone_number": "937-643-0091",
"fax_number": "866-409-5783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLELLAN",
"first_name": "ERIC",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2014-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "E3231",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E3231",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "19432000",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPSYCH",
"identifier": "165435",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH",
"identifier": "6280674",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "947770",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kettering, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.