Individual provider Active NPI

Wendy L Holdsworth

  • Professional Counselor
  • Miamisburg, OH
National Provider Identifier
1538630975
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2303332 Issued in OH
Practice address
9049 Springboro Pike
Miamisburg, OH 45342-4926
Phone
(937) 759-0545
NPI assigned
Dec 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X E.2303332 OH
Mental Health Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XM0800X
Mental Health Occupational Therapist 225XM0800X C.2002669 OH
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X E.2303332 OH Primary

Addresses

Primary practice location

9049 Springboro Pike
Miamisburg, OH 45342-4926

Mailing address

9049 Springboro Pike
Miamisburg, OH 45342-4926
Phone (937) 759-0545

Other identifiers 1

IdentifierTypeStateIssuer
0335167MedicaidOH

Other names 1

  • Wendy Rutledge Former name

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
E.2303332OHMDMental Health Counselor
C.2002669OHMDMental Health Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Woodstream Wellness Mental Health CurrentSince Feb 8, 2023 Accepting new patients
WS Wellness LLC Mental Health CurrentSince Aug 1, 2023 Accepting new patients

Locations

3330 Erie Ave
Ste 7
Cincinnati, OH 45208
Phone (937) 759-0545

4770 Duke Dr
Ste 202
Mason, OH 45040
Phone (937) 759-0545

9049 Springboro Pike
Miamisburg, OH 45342
Phone (937) 759-0545

9049 Springboro Pike
Ste A
Miamisburg, OH 45342
Phone (937) 759-0545

Organizations & group practices 2

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": "1544486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1538630975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9049 SPRINGBORO PIKE",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453424926",
            "telephone_number": "937-759-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9049 SPRINGBORO PIKE",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453424926",
            "telephone_number": "937-759-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDSWORTH",
        "first_name": "WENDY",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-11",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2303332",
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "OH",
            "license": "C.2002669",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2303332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0335167",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "RUTLEDGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miamisburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.