Individual provider Active NPI

Stephanie Hope Alexandra Billingsley Ezea, LPCC-S

  • Professional Counselor
  • Middletown, OH
National Provider Identifier
1487027595
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0800287 Issued in OH
Practice address
4464 S Dixie Hwy
Middletown, OH 45005-5464
Phone
(513) 649-8008
Fax
(513) 649-8004
NPI assigned
Nov 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA080412 OH
Mental Health Counselor 101YM0800X E0800287 OH
Professional Counselor 101YP2500X E.0800287 OH Primary

Addresses

Primary practice location

4464 S Dixie Hwy
Middletown, OH 45005-5464

Mailing address

6501 Germantown Rd Lot 131
Middletown, OH 45042-1226
Phone (513) 389-6009

Other identifiers 4

IdentifierTypeStateIssuer
0074861OtherMEDICAID-ODADAS
01-0693OtherOHCARF CERTIFICATION
H130910OtherOHMEDICARE GROUP PTAN
0074946OtherOHMEDICAID-ODMH

Other names 1

  • Stepahnie Billingsley Former name

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
I20240205001106 OH Practitioner - Mental Health Counselor 7214370592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agape Counseling Center LLCGroup PAC ID 4880024843, 5 clinicians

Practice addresses (Care Compare)

175 S Main St
Centerville, OH 45458-2372
Phone (937) 434-0540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CDCA080412OHMDAddiction (Substance Use Disorder) Counselor
E0800287OHMDMental Health Counselor
E.0800287OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Access Counseling Services LLC Addiction (Substance Use Disorder) CurrentSince Dec 1, 2019 Accepting new patients
Agape Counseling Center LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Access Counseling Services, LLC Addiction (Substance Use Disorder) PastSince Dec 1, 2019 Accepting new patients
Paul D Entner PastSince Jan 1, 2024 Accepting new patients

Locations

175 S Main St
Centerville, OH 45458
Phone (937) 434-0540

4464 S Dixie Hwy
Middletown, OH 45005
Phone 5136498008 ext. 22

Organizations & group practices 4

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": "1447200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1487027595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 GERMANTOWN RD LOT 131",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450421226",
            "telephone_number": "513-389-6009"
        },
        {
            "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": "BILLINGSLEY EZEA",
        "first_name": "STEPHANIE",
        "middle_name": "HOPE ALEXANDRA",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-11",
        "last_updated": "2022-07-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA080412",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E0800287",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0800287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID-ODADAS",
            "identifier": "0074861",
            "state": null
        },
        {
            "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": "MEDICAID-ODMH",
            "identifier": "0074946",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPAHNIE",
            "last_name": "BILLINGSLEY",
            "credential": "LPCC-S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.