Individual provider Active NPI

Melissa I Wucinick, LPC, LCDCIII

  • Addiction (Substance Use Disorder) Counselor
  • Dover, OH
National Provider Identifier
1437540986
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCDC 131239-3 Issued in OH
Practice address
897 E Iron Ave
Dover, OH 44622-2030
Phone
(330) 343-5555
NPI assigned
Feb 5, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDC 131239-3 OH Primary
Mental Health Counselor 101YM0800X C 1200460 OH

Addresses

Primary practice location

897 E Iron Ave
Dover, OH 44622-2030

Mailing address

3726 Vernon Ave NW
Canton, OH 44709-2421
Phone (330) 343-5555

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

LicenseStateTypeSpecialty
LCDC 131239-3OHMDAddiction (Substance Use Disorder) Counselor
C 1200460OHMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1437540986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 VERNON AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447092421",
            "telephone_number": "330-343-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "897 E IRON AVE",
            "city": "DOVER",
            "state": "OH",
            "postal_code": "446222030",
            "telephone_number": "330-343-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUCINICK",
        "first_name": "MELISSA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "LPC, LCDCIII",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDC 131239-3",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C 1200460",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; 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.