Individual provider Active NPI

Matthew Harvey Stricklin Jr., MDIV, MSED, LPCC

  • Professional Counselor
  • Milford, OH
National Provider Identifier
1558412445
Registry record updated Nov 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0700182-SUPV Issued in OH
Practice address
5936 Woodspoint Dr
Milford, OH 45150-2157
Phone
(513) 535-6053
NPI assigned
Jan 16, 2007
Last updated
Nov 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E. 0700182 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X CERTIFICATION 050075 OH
Professional Counselor 101YP2500X E.0700182-SUPV OH Primary

Addresses

Primary practice location

5936 Woodspoint Dr
Milford, OH 45150-2157

Mailing address

5936 Woodspoint Dr
Milford, OH 45150-2157
Phone (513) 535-6053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240612000459 OH Practitioner - Mental Health Counselor 4981146438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

20 S 3Rd St
Suite 210
Columbus, OH 43215-4206
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CERTIFICATION 050075OHMDAddiction (Substance Use Disorder) Counselor
E. 0700182OHMDProfessional Counselor
E.0700182-SUPVOHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Professional CurrentSince May 2, 2024 Accepting new patients
Three Waters Recovery Center, LLC PastSince Apr 1, 2024 Accepting new patients

Locations

20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731110400000",
    "number": "1558412445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5936 WOODSPOINT DR",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451502157",
            "telephone_number": "513-535-6053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5936 WOODSPOINT DR",
            "city": "MILFORD",
            "state": "OH",
            "postal_code": "451502157",
            "telephone_number": "513-535-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRICKLIN",
        "first_name": "MATTHEW",
        "middle_name": "HARVEY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MDIV, MSED, LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-11-09",
        "certification_date": "2024-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E. 0700182",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CERTIFICATION 050075",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0700182-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, OH

Sources for this page

Verify at the official NPI Registry.