Individual provider Active NPI

Gavin Noah, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Milford, OH
National Provider Identifier
1487008116
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
140763 Issued in OH
Practice address
50 W Techne Center Dr
Milford, OH 45150-8403
Phone
(513) 753-9964
Fax
(513) 753-9968
NPI assigned
Apr 19, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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 140763 OH Primary

Addresses

Primary practice location

50 W Techne Center Dr
Milford, OH 45150-8403

Mailing address

4575 State Route 124
Lynchburg, OH 45142-9374
Phone (937) 509-1609

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
140763OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1487008116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4575 STATE ROUTE 124",
            "city": "LYNCHBURG",
            "state": "OH",
            "postal_code": "451429374",
            "telephone_number": "937-509-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W TECHNE CENTER DR",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451508403",
            "telephone_number": "513-753-9964",
            "fax_number": "513-753-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOAH",
        "first_name": "GAVIN",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "140763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.