Individual provider Active NPI

Sean M. Blyth, LICDC

  • Addiction (Substance Use Disorder) Counselor
  • Cincinnati, OH
National Provider Identifier
1588199244
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LICDC141011 Issued in OH
Practice address
453 Ada St
Cincinnati, OH 45219-1103
Phone
(513) 675-7632
NPI assigned
May 1, 2017
Last updated
May 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC141011 OH Primary
Social Worker 104100000X S.1701726 OH

Addresses

Primary practice location

453 Ada St
Cincinnati, OH 45219-1103

Mailing address

453 Ada St
Cincinnati, OH 45219-1103
Phone (513) 675-7632

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
I20250703000427 OH Practitioner - Mental Health Counselor 5597278317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saba a Chughtai, LLCGroup PAC ID 9739231937, 3 clinicians

Practice addresses (Care Compare)

5740 Gateway
Suite 104
Mason, OH 45040-1893
Phone (513) 234-7870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICDC141011OHMDAddiction (Substance Use Disorder) Counselor
S.1701726OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Saba a Chughtai LLC CurrentSince May 1, 2025 Accepting new patients

Locations

5740 Gateway
Ste 104
Mason, OH 45040
Phone (513) 234-7870

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": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1588199244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 ADA ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452191103",
            "telephone_number": "513-675-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 ADA ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452191103",
            "telephone_number": "513-675-7632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLYTH",
        "first_name": "SEAN",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-01",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC141011",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1701726",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.