Madeline Slack, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.2001693-SUPV Issued in OH

Practice address

104 N Main St
Marysville, OH 43040-1106

Phone

(937) 537-5100

NPI assigned

Sep 28, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Lighthouse Behavioral Health Solutions, LLCGroup PAC ID 4486089893, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Lighthouse Behavioral Health Solutions, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Columbus, OH
  • NPI 1629560230
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710633600000",
    "number": "1457860850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 MORGAN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452062348",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N MAIN ST",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430401106",
            "telephone_number": "937-537-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4660 Roberts Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432289671",
            "country_code": "US",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLACK",
        "first_name": "MADELINE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2024-03-17",
        "certification_date": "2024-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2001693-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0266106",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jemima N/a Shuti
• Megan Simon
• Lori S Simpkins, LPN
• Kelli A Singleton, LSW
• Caitlin Tobey Sirois, M.S., CCC-SLP
• Megan Sligh, M.ED. ED.S.
• Paula Smarra, M.A.CCC-SLP
• Karen Sue Smith, PA-C
• Rick L Smith
• Victoria Elizabeth Smith

• Professional Counselor in Marysville, OH
• Providers in Marysville, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2024; 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.