Benjamin K Grzelak, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA-162499 Issued in OH

Practice address

953 S South St
Wilmington, OH 45177-2921

Phone

(937) 383-4441

Fax

(937) 383-2916

NPI assigned

Jan 20, 2017

Last updated

Jan 20, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1484870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1528505153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 COOK RD",
            "address_2": "SUITE 400",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450369600",
            "telephone_number": "513-228-7800",
            "fax_number": "513-725-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "953 S SOUTH ST",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772921",
            "telephone_number": "937-383-4441",
            "fax_number": "937-383-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZELAK",
        "first_name": "BENJAMIN",
        "middle_name": "K",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-20",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA-162499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Wilmington, OH
• Providers in Wilmington, 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 Jan 20, 2017; 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.