Individual provider Active NPI

Lena Rae Wooton, M.ED., LPCC-S

  • Professional Counselor
  • Portsmouth, OH
National Provider Identifier
1548564669
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.1700434-SUPV Issued in OH
Practice address
602 Chillicothe St Ste M111
Portsmouth, OH 45662-4079
Phone
(941) 445-0462
Fax
(941) 445-0462
NPI assigned
Jan 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X E.1700434-SUPV OH Primary

Addresses

Primary practice location

602 Chillicothe St Ste M111
Portsmouth, OH 45662-4079

Mailing address

602 Chillicothe St Ste M111
Portsmouth, OH 45662-4079
Phone (941) 445-0462

Other practice location 1

3830 Evans Ave
Fort Myers, FL 33901-9305
Phone (239) 939-2808

Other identifiers 2

IdentifierTypeStateIssuer
070980800MedicaidOH
070980800MedicaidFL

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
E.1700434-SUPVOHMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1548564669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 CHILLICOTHE ST STE M111",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624079",
            "telephone_number": "941-445-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 CHILLICOTHE ST STE M111",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624079",
            "telephone_number": "941-445-0462",
            "fax_number": "941-445-0462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3830 Evans Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339019305",
            "country_code": "US",
            "telephone_number": "239-939-2808",
            "fax_number": "239-939-5096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOOTON",
        "first_name": "LENA",
        "middle_name": "RAE",
        "credential": "M.ED., LPCC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-04",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1700434-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070980800",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070980800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.