Individual provider Active NPI

Teresa A Paul, LPCC-S

  • Professional Counselor
  • Middletown, OH
National Provider Identifier
1467679183
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0004365-SUPV Issued in OH
Practice address
4464 S Dixie Hwy
Middletown, OH 45005-5464
Phone
(513) 649-8008
Fax
(513) 649-8004
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X E.0004365-SUPV OH
Professional Counselor 101YP2500X E.0004365-SUPV OH Primary

Addresses

Primary practice location

4464 S Dixie Hwy
Middletown, OH 45005-5464

Mailing address

4464 S Dixie Hwy
Middletown, OH 45005-5464
Phone (513) 649-8008

Other identifiers 4

IdentifierTypeStateIssuer
01-0693OtherOHCARF CERTIFICATION
H130910OtherOHMEDICARE GROUP PTAN
0074861OtherOHOHIO DEPARTMENT ALCOHOL DRUG SERVICES (ODADAS)
0074946OtherOHOHIO DEPARTMENT MENTAL HEALTH (ODMH)

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
E.0004365-SUPVOHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Access Counseling Services LLC Mental Health PastSince Nov 4, 2014 Accepting new patients
Access Counseling Services, LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1467679183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4464 S DIXIE HWY",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055464",
            "telephone_number": "513-649-8008",
            "fax_number": "513-649-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4464 S DIXIE HWY",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055464",
            "telephone_number": "513-649-8008",
            "fax_number": "513-649-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "TERESA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.0004365-SUPV",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0004365-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARF CERTIFICATION",
            "identifier": "01-0693",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "H130910",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO DEPARTMENT ALCOHOL DRUG SERVICES (ODADAS)",
            "identifier": "0074861",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO DEPARTMENT MENTAL HEALTH  (ODMH)",
            "identifier": "0074946",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.