Active NPI
Susan Kylene Wilson
- Addiction (Substance Use Disorder) Counselor
- Toledo, OH
National Provider Identifier
1457824534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 166886
- Practice address
- 3170 W Central Ave
Toledo, OH 43606-2945 - Phone
- (567) 316-7253
- NPI assigned
- Jan 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 166886 | OH | Primary |
Addresses
Primary practice location
3170 W Central Ave
Toledo, OH 43606-2945
Mailing address
128 S 8TH St
Upper Sandusky, OH 43351-1353
Phone (419) 508-9601
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 |
|---|---|---|---|
| 166886 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547078400000",
"number": "1457824534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 S 8TH ST",
"city": "UPPER SANDUSKY",
"state": "OH",
"postal_code": "433511353",
"telephone_number": "419-508-9601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3170 W CENTRAL AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436062945",
"telephone_number": "567-316-7253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SUSAN",
"middle_name": "KYLENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-10",
"last_updated": "2019-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "166886",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.