Active NPI
Daniel Wick
- Professional Counselor
- Dayton, OH
National Provider Identifier
1427588060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.0003656-SUPV
- Practice address
- 1 Elizabeth PL Ste 190
Dayton, OH 45417-3445 - Phone
- (937) 652-6811
- NPI assigned
- Jun 15, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E.0003656-SUPV | OH | Primary |
Addresses
Primary practice location
1 Elizabeth PL Ste 190
Dayton, OH 45417-3445
Mailing address
4751 Fisher Twin Rd
West Alexandria, OH 45381-8309
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0119089 | Medicaid | OH | |
| 0117471 | Medicaid | OH |
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 |
|---|---|---|---|
| E.0003656-SUPV | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497484800000",
"number": "1427588060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4751 FISHER TWIN RD",
"city": "WEST ALEXANDRIA",
"state": "OH",
"postal_code": "453818309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ELIZABETH PL STE 190",
"city": "DAYTON",
"state": "OH",
"postal_code": "454173445",
"telephone_number": "937-652-6811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICK",
"first_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-15",
"last_updated": "2017-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.0003656-SUPV",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0119089",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0117471",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.