John Shealy, LISW, LICDC-CS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

I0018420SUPV Issued in OH

Practice address

118 Stover Dr
Delaware, OH 43015-8601

Phone

(740) 369-6811

Fax

(740) 363-8742

NPI assigned

Apr 17, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1508209834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 STOVER DR",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430158601",
            "telephone_number": "740-369-6811",
            "fax_number": "740-363-8742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 STOVER DR",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430158601",
            "telephone_number": "740-369-6811",
            "fax_number": "740-363-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEALY",
        "first_name": "JOHN",
        "credential": "LISW, LICDC-CS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-17",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "I0018420SUPV",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I0018420SUPV",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2901088",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John C Sexton
• Rosemary Seymour
• Carlee Shafer, AT
• Kavita S. Sharma, M.D.
• Eleanor R Shaw, FNP
• Kevann Kimberly Sheets, LPN
• Pamela M Sheets, M.A.
• Kevin Shelton
• Audrey Shifflett, MA, CCC-SLP
• Jenna Shipman, OT

• Addiction (Substance Use Disorder) Counselor in Delaware, OH
• Providers in Delaware, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.