Organization Active NPI

Miami Valley Counseling & Hypnosis Center

  • Professional Counselor
  • Beavercreek, OH
National Provider Identifier
1437132974
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E-0000123 Issued in OH
Legal business name
MIAMI VALLEY COUNSELING & HYPNOSIS CENTER
Practice address
1255 N Fairfield Rd
Beavercreek, OH 45432-2668
Phone
(937) 426-5225
Fax
(937) 426-7526
NPI assigned
Nov 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Authorized official

Name
Sharon A Desorcy-MarcotteNPI 1215051768
Title
President
Phone
(937) 426-5225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X E-0000123 OH Primary

Addresses

Primary practice location

1255 N Fairfield Rd
Beavercreek, OH 45432-2668

Mailing address

1255 N Fairfield Rd
Beavercreek, OH 45432-2668
Phone (937) 426-5225

Other identifiers 4

IdentifierTypeStateIssuer
000000010860OtherOHANTHEM BCBS PIN
281384690-001OtherOHMEDICAL MUTUAL PIN
248755000OtherOHMAGELLAN PIN
281384690OtherOHTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241216001448 OH Part B Supplier - Clinic/Group Practice 4587190434 Receives reassigned benefits from 1 practitioner
Practice locations: Beavercreek, OH

National Provider Directory

National Provider Directory

Locations

1255 N Fairfield Rd
Beavercreek, OH 45432
Phone (937) 426-5225

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1437132974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 N FAIRFIELD RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322668",
            "telephone_number": "937-426-5225",
            "fax_number": "937-426-7526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 N FAIRFIELD RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322668",
            "telephone_number": "937-426-5225",
            "fax_number": "937-426-7526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAMI VALLEY COUNSELING & HYPNOSIS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "DESORCY-MARCOTTE",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-426-5225"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E-0000123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS PIN",
            "identifier": "000000010860",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL PIN",
            "identifier": "281384690-001",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PIN",
            "identifier": "248755000",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "281384690",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.