Active NPI
Diedre Rose Fleming, MS, MSW, LICDC, LSW
- Addiction (Substance Use Disorder) Counselor
- Ashtabula, OH
National Provider Identifier
1578050720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCDCIII.161336
- Practice address
- 2801 C CT
Ashtabula, OH 44004-4577 - Phone
- (440) 998-4210
- NPI assigned
- Apr 13, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | S.2005340 | OH | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LICDC.162024 | OH | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCDCIII.161336 | OH | Primary |
Addresses
Primary practice location
2801 C CT
Ashtabula, OH 44004-4577
Mailing address
2801 C CT
Ashtabula, OH 44004-4577
Phone (440) 998-0722
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12557 Ravenwood Dr
Chardon, OH 44024-9009
Phone (440) 285-3568
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCDCIII.161336 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| LICDC.162024 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| S.2005340 | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ravenwood Mental Health Center | Addiction (Substance Use Disorder) | Current | Accepting new patients |
| Community Counseling Center of Ashtabula County | Current | Accepting new patients | |
| Ravenwood Mental Health Center | Current | Accepting new patients | |
| Crossroads Health | Past | Accepting new patients |
Locations
2801 C Ct
Ashtabula, OH 44004
Phone (440) 998-0722
12557 Ravenwood Dr
Concord Twp, OH 44024
Phone (440) 990-6104
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/ravenwoodhealth/r4/
Organizations & group practices 5
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.
-
- Community/Behavioral Health Agency
- Chardon, OH
- NPI 1730356296
-
- Adolescent and Children Mental Health Clinic/Center
- Ashtabula, OH
- NPI 1720029622
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chardon, OH
- NPI 1053345975
-
- Addiction (Substance Use Disorder) Counselor
- Chardon, OH
- NPI 1912265794
-
- Adolescent and Children Mental Health Clinic/Center
- Mentor, OH
- NPI 1356303911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718236800000",
"number": "1578050720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 C CT",
"city": "ASHTABULA",
"state": "OH",
"postal_code": "440044577",
"telephone_number": "440-998-0722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 C CT",
"city": "ASHTABULA",
"state": "OH",
"postal_code": "440044577",
"telephone_number": "440-998-4210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLEMING",
"first_name": "DIEDRE",
"middle_name": "ROSE",
"name_prefix": "Ms.",
"credential": "MS, MSW, LICDC, LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-13",
"last_updated": "2024-06-13",
"certification_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "S.2005340",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "LICDC.162024",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "LCDCIII.161336",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ashtabula, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.