Active NPI
John Ray Wheeler, LPCC
- Mental Health Counselor
- Dayton, OH
National Provider Identifier
1619445699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C.1901918
- Practice address
- 118 W 1St St Ste 308
Dayton, OH 45402-1150 - Phone
- (937) 319-4448
- Fax
- (855) 978-1771
- NPI assigned
- Nov 7, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C.1901918 | OH | Primary |
Addresses
Primary practice location
118 W 1St St Ste 308
Dayton, OH 45402-1150
Mailing address
118 W 1St St Ste 308
Dayton, OH 45402-1150
Phone (937) 319-4448
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0330742 | Medicaid | OH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| C.1901918 | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forward Therapeutics LLC | Mental Health | Current | Accepting new patients |
| Darcie R Clark LPCC LLC | Mental Health | Past | Accepting new patients |
Locations
118 W 1st St
Ste 308
Dayton, OH 45402
Phone (937) 319-4448
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 and National Provider Directory roles.
-
- Mental Health Counselor
- Dayton, OH
- NPI 1053981605
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683590400000",
"number": "1619445699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 W 1ST ST STE 308",
"city": "DAYTON",
"state": "OH",
"postal_code": "454021150",
"telephone_number": "937-319-4448",
"fax_number": "855-978-1771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 W 1ST ST STE 308",
"city": "DAYTON",
"state": "OH",
"postal_code": "454021150",
"telephone_number": "937-319-4448",
"fax_number": "855-978-1771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELER",
"first_name": "JOHN",
"middle_name": "RAY",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-07",
"last_updated": "2023-05-09",
"certification_date": "2023-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "C.1901918",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0330742",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.