Individual provider Active NPI

Michael I Letts, LCDCII

  • Addiction (Substance Use Disorder) Counselor
  • Fairborn, OH
National Provider Identifier
1528514510
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCDC.151106-2 Issued in OH
Practice address
302 W Main St
Fairborn, OH 45324-5037
Phone
(937) 281-4673
Fax
(937) 318-1120
NPI assigned
Aug 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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 LCDC.151106-2 OH Primary

Addresses

Primary practice location

302 W Main St
Fairborn, OH 45324-5037

Mailing address

3103 Dixie Hwy
Hamilton, OH 45015-1653
Phone (513) 892-4673

Other practice location 1

301 W 1st St Fl 2
Dayton, OH 45402-3033
Phone (937) 528-3923

Other practice location 2

777 Columbus Ave Ste 7-D
Lebanon, OH 45036-1684
Phone (513) 228-6590

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
LCDC.151106-2OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Decoach Team LLC CurrentSince Nov 16, 2021 Accepting new patients
Decoach Team LLC CurrentSince Nov 16, 2021 Accepting new patients
Recovery Defined, LLC PastSince Sep 25, 2019 Accepting new patients

Locations

3103 Dixie Hwy
Hamilton, OH 45015
Phone (513) 892-4673

Organizations & group practices 3

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": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1528514510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 DIXIE HWY",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450151653",
            "telephone_number": "513-892-4673",
            "fax_number": "513-737-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W MAIN ST",
            "city": "FAIRBORN",
            "state": "OH",
            "postal_code": "453245037",
            "telephone_number": "937-281-4673",
            "fax_number": "937-318-1120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 W 1st St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454023033",
            "country_code": "US",
            "telephone_number": "937-528-3923",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "777 Columbus Ave Ste 7-D",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OH",
            "postal_code": "450361684",
            "country_code": "US",
            "telephone_number": "513-228-6590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LETTS",
        "first_name": "MICHAEL",
        "middle_name": "I",
        "credential": "LCDCII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDC.151106-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairborn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.