Individual provider Active NPI

Cezar Deon Stewart, LICDC.163053

  • Addiction (Substance Use Disorder) Counselor
  • Copley, OH
National Provider Identifier
1558027342
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LICDC.163053 Issued in OH
Practice address
155 Montrose West Ave
Copley, OH 44321-3121
Phone
(330) 933-4649
NPI assigned
Nov 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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 LICDC.163053 OH Primary

Addresses

Primary practice location

155 Montrose West Ave
Copley, OH 44321-3121

Mailing address

2643 Elmwood St
Cuyahoga Falls, OH 44221-2608
Phone (330) 705-3844

Other identifiers 1

IdentifierTypeStateIssuer
0008762MedicaidOH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCDCII.161795OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Light Center Recovery LLC Addiction (Substance Use Disorder) PastSince Mar 1, 2023 Accepting new patients

Organizations & group practices 1

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": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1558027342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2643 ELMWOOD ST",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442212608",
            "telephone_number": "330-705-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MONTROSE WEST AVE",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443213121",
            "telephone_number": "330-933-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "CEZAR",
        "middle_name": "DEON",
        "credential": "LICDC.163053",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-16",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.163053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008762",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Copley, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.