Active NPI
Douglas Wilson, CDCA
- Addiction (Substance Use Disorder) Counselor
- Lima, OH
National Provider Identifier
1427633411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.184786
- Practice address
- 1505 N Cole St
Lima, OH 45801-2432 - Phone
- (833) 510-4357
- Fax
- (866) 460-2997
- NPI assigned
- Mar 11, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | APS.002194 | OH | |
| Case Manager/Care Coordinator | 171M00000X | 180516 | OH | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.184786 | OH | Primary |
Addresses
Primary practice location
1505 N Cole St
Lima, OH 45801-2432
Mailing address
4600 Montgomery Rd Ste 400
Cincinnati, OH 45212-2600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0315095 | 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 |
|---|---|---|---|
| CDCA.184786 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| 180516 | OH | MD | Case Manager/Care Coordinator |
| APS.002194 | OH | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima-Urban Minority Alcoholism and Drug Abuse Outreach Program., Inc | Current | Accepting new patients | |
| Lima-Urban Minority Alcoholism and Drug Abuse Outreach Program., Inc | Current | Accepting new patients |
Locations
311 E Market St
Fl 3
Lima, OH 45801
Phone (419) 222-4474
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Lima, OH
- NPI 1336780196
-
- Community Health Clinic/Center
- Lima, OH
- NPI 1629144050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777852800000",
"number": "1427633411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 MONTGOMERY RD STE 400",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452122600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 N COLE ST",
"city": "LIMA",
"state": "OH",
"postal_code": "458012432",
"telephone_number": "833-510-4357",
"fax_number": "866-460-2997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DOUGLAS",
"credential": "CDCA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-11",
"last_updated": "2026-05-04",
"certification_date": "2026-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OH",
"license": "APS.002194",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "OH",
"license": "180516",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.184786",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0315095",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lima, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.