Individual provider Active NPI

Morgan Basham

  • Addiction (Substance Use Disorder) Counselor
  • Portsmouth, OH
National Provider Identifier
1568908291
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
162536 Issued in OH
Practice address
602 Chillicothe St
Suite 429
Portsmouth, OH 45662-4093
Phone
(740) 529-7356
NPI assigned
Jan 19, 2017
Last updated
Jan 19, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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 162536 OH Primary

Addresses

Primary practice location

602 Chillicothe St
Suite 429
Portsmouth, OH 45662-4093

Mailing address

602 Chillicothe St
Q
Portsmouth, OH 45662-4093
Phone (740) 529-7356

Other identifiers 1

IdentifierTypeStateIssuer
101YA0400XMedicaidOH

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
162536OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Port45 Recovery LLC Addiction (Substance Use Disorder) Past 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, 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": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1568908291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 CHILLICOTHE ST",
            "address_2": "Q",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624093",
            "telephone_number": "740-529-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 CHILLICOTHE ST",
            "address_2": "SUITE 429",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624093",
            "telephone_number": "740-529-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHAM",
        "first_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "162536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YA0400X",
            "state": "OH"
        }
    ],
    "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 Jan 19, 2017; 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.