Individual provider Active NPI

Thomas Ross Dewey, LPCC

  • Professional Counselor
  • Youngstown, OH
National Provider Identifier
1477057388
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2001770 Issued in OH
Practice address
4531 Belmont Ave Ste 9
Youngstown, OH 44505-1041
Phone
(330) 759-5270
NPI assigned
Mar 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C.1800900 OH
Professional Counselor 101YP2500X E.2001770 OH Primary

Addresses

Primary practice location

4531 Belmont Ave Ste 9
Youngstown, OH 44505-1041

Mailing address

1064 Pallette Dr NE
Warren, OH 44484-1726
Phone (330) 974-8114

Other practice location 1

1725 Drexel Ave NW
Warren, OH 44485-2121
Phone (330) 539-3200

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240108004649 OH Practitioner - Mental Health Counselor 4688093818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Water Counseling and Recovery LLCGroup PAC ID 8527487750, 16 clinicians

Practice addresses (Care Compare)

1716 N Rd SE
Warren, OH 44484-2907
Phone (330) 539-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1800900OHMDProfessional Counselor
E.2001770OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Open Water Counseling and Recovery, LLC CurrentSince Oct 4, 2019 Accepting new patients
Open Water Counseling and Recovery, LLC CurrentSince Dec 1, 2019 Accepting new patients

Locations

1716 North Rd SE
Warren, OH 44484
Phone (330) 399-9776

1725 Drexel Ave NW
Warren, OH 44485
Phone (330) 539-3200

Interoperability endpoints

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

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": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1477057388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 PALLETTE DR NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841726",
            "telephone_number": "330-974-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 BELMONT AVE STE 9",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051041",
            "telephone_number": "330-759-5270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 Drexel Ave NW",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444852121",
            "country_code": "US",
            "telephone_number": "330-539-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEWEY",
        "first_name": "THOMAS",
        "middle_name": "ROSS",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-23",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1800900",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2001770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.