NPIMap

Individual provider Active NPI

Jessica Marie Biederman, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Maumee, OH
National Provider Identifier
1447901954
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
179452 Issued in OH
Practice address
1757 Indian Wood Cir
Maumee, OH 43537-4009
Phone
(567) 302-3025
NPI assigned
Jan 17, 2022
Last updated
Jan 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 179452 OH Primary

Addresses

Primary practice location

1757 Indian Wood Cir
Maumee, OH 43537-4009

Mailing address

1757 Indian Wood Cir
Maumee, OH 43537-4009
Phone (567) 302-3025

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Kipu

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
179452OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Detox Center LLC Past Accepting new patients
Midwest Detox Center LLC Past Accepting new patients
Valor Recovery Center of Youngstown LLC Past Accepting new patients
Midwest Recovery Center LLC Past Accepting new patients
Midwest Recovery Center LLC Past Accepting new patients
Valor Recovery Center of Youngstown LLC Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1447901954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1757 INDIAN WOOD CIR",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374009",
            "telephone_number": "567-302-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 INDIAN WOOD CIR",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374009",
            "telephone_number": "567-302-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIEDERMAN",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "179452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Kipu",
            "affiliation": "N",
            "address_1": "1757 Indian Wood Cir",
            "city": "Maumee",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435374009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.