Individual provider Active NPI

Angel Nicole O'Laughlin, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Willoughby, OH
National Provider Identifier
1477364271
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.194827 Issued in OH
Practice address
5621 Som Center Rd
Willoughby, OH 44094-3011
Phone
(216) 774-4704
NPI assigned
Jan 20, 2025
Last updated
Oct 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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 CDCA.194827 OH Primary

Addresses

Primary practice location

5621 Som Center Rd
Willoughby, OH 44094-3011

Mailing address

5621 Som Center Rd
Willoughby, OH 44094-3011
Phone (216) 774-4704

Other practice location 1

23611 Chagrin Blvd Ste 103
Beachwood, OH 44122-5540
Phone (844) 316-7599 ext. 103

Other identifiers 1

IdentifierTypeStateIssuer
0104472MedicaidOH

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
190595OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Attain BH Toledo LLC Past Accepting new patients

Organizations & group practices 1

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": "1737331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1477364271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5621 SOM CENTER RD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440943011",
            "telephone_number": "216-774-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5621 SOM CENTER RD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440943011",
            "telephone_number": "216-774-4704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23611 Chagrin Blvd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Beachwood",
            "state": "OH",
            "postal_code": "441225540",
            "country_code": "US",
            "telephone_number": "844-316-7599 x103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'LAUGHLIN",
        "first_name": "ANGEL",
        "middle_name": "NICOLE",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-20",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.194827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0104472",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; 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.