Individual provider Active NPI

Jacqueline L Richied-Rust

  • Mental Health Counselor
  • Eaton, OH
National Provider Identifier
1619111945
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C0001861 Issued in OH
Practice address
2172A US Route 127 N
Eaton, OH 45320-9289
Phone
(937) 456-1915
Fax
(937) 456-2208
NPI assigned
Apr 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C0001861 OH Primary

Addresses

Primary practice location

2172A US Route 127 N
Eaton, OH 45320-9289

Mailing address

2172A US Route 127 N
Eaton, OH 45320-9289
Phone (937) 456-1915

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
C0001861OHMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1619111945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2172A US ROUTE 127 N",
            "city": "EATON",
            "state": "OH",
            "postal_code": "453209289",
            "telephone_number": "937-456-1915",
            "fax_number": "937-456-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2172A US ROUTE 127 N",
            "city": "EATON",
            "state": "OH",
            "postal_code": "453209289",
            "telephone_number": "937-456-1915",
            "fax_number": "937-456-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHIED-RUST",
        "first_name": "JACQUELINE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-30",
        "last_updated": "2009-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C0001861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eaton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; 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.