Pamela Belle Dustman, PCC-S LICDC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E2125 Issued in OH

Practice address

65 N Lake St
Madison, OH 44057-3113

Phone

(440) 428-0055

Fax

(440) 428-0084

NPI assigned

May 4, 2011

Last updated

May 4, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phoenix Group Home, LLC

  dba PATH Integrated Healthcare

  • Community/Behavioral Health Agency
  • Portsmouth, OH
  • NPI 1083146013
  Medicare reassignment NPD
• Phoenix Group Home, LLC

  dba Path Behavioral Health- SUD

  • Substance Abuse Rehabilitation Facility
  • Cincinnati, OH
  • NPI 1336654854
  NPD

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1447542766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N LAKE ST",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440573113",
            "telephone_number": "440-428-0055",
            "fax_number": "440-428-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N LAKE ST",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440573113",
            "telephone_number": "440-428-0055",
            "fax_number": "440-428-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSTMAN",
        "first_name": "PAMELA",
        "middle_name": "BELLE",
        "name_prefix": "Ms.",
        "credential": "PCC-S LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "981326",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E2125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donch and Baker, O.D. Eye Doctors of Madison, LLC
• Jeanne L Donze, PCC
• Dr Frank Sailors & Associates Inc
• Dr. Edward S. Friedman, Optometrist Inc.
• Drayer Physical Therapy Institute LLC
• Dva Healthcare Renal Care Inc (North Ridge Dialysis)
• Eastwood Residential Living, Inc.
• Larry Edward Ede, NP
• Embassy Madison Management, LLC (Madison Health Care)
• Embassy Madison Management, LLC (Madison Health Care)

• Mental Health Counselor in Madison, OH
• Providers in Madison, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.