Phylissa Daquino, LPCC
Individual provider Active NPI Professional Counselor · Kenton, OH
NPI 1518484286 · NPPES record last updated Feb 2, 2024
Key facts
- NPI
- 1518484286
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- E.2203068 (OH)
- Practice address
- 631 Silver St
Kenton, OH 43326-1499 - Phone
- (419) 673-7248
- NPI assigned
- Aug 24, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240104002625 | OH | Practitioner - Mental Health Counselor | 8426409327 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.2203068 | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Partners of Western Ohio | Current |
Accepting new patients | |
| Health Partners of Western Ohio | Current |
Accepting new patients | |
| Health Partners of Western Ohio | Current | Accepting new patients | |
| Health Partners of Western Ohio | Past | Accepting new patients | |
| Health Partners of Western Ohio | Past | Accepting new patients |
Locations
200 Harding Ave
Kenton, OH 43326
Phone (419) 673-1286
631 Wildcat Way
Rm 1409
Kenton, OH 43326
Phone (419) 673-0775
631 Wildcat Way
Kenton, OH 43326
Phone (419) 673-7248
329 N West St
Lima, OH 45801
Phone (419) 229-6007
1 Spartan Way
Lima, OH 45801
Phone (419) 222-3546
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E.2203068 | OH | Yes |
Addresses
Primary practice location
631 Silver St
Kenton, OH 43326-1499
Mailing address
329 N West St
Lima, OH 45801-4332
Phone (419) 221-3072
Other providers in Kenton, OH
- Kellie Marie Cramer
- Kristiana Creamer
- Krista M Crowley
- Christina Marie Crum
- Barbara Ann Daniels
- Kalyan K Das
- David L. Wigton D.C. Inc
- Cole Edward Dearing
- Melissa Ann Decker
- Deol Dental Kenton LLC
All providers in Kenton, OH · Professional Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.