Individual provider Active NPI

Dustin C McMillen

  • Addiction (Substance Use Disorder) Counselor
  • Bucyrus, OH
National Provider Identifier
1639607401
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.179824 Issued in OH
Practice address
2458 Stetzer Rd
Bucyrus, OH 44820-2066
Phone
(419) 562-2000
Fax
(419) 562-1296
NPI assigned
May 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.179824 OH Primary

Addresses

Primary practice location

2458 Stetzer Rd
Bucyrus, OH 44820-2066

Mailing address

2458 Stetzer Rd
Bucyrus, OH 44820-2066
Phone (419) 562-2000

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
CDCA.179824OHMDAddiction (Substance Use Disorder) Counselor

Interoperability endpoints

  • Direct secure messaging: dustin.mcmillin.p1@direct.centerstreetclinic.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1639607401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2458 STETZER RD",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448202066",
            "telephone_number": "419-562-2000",
            "fax_number": "419-562-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2458 STETZER RD",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448202066",
            "telephone_number": "419-562-2000",
            "fax_number": "419-562-1296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLEN",
        "first_name": "DUSTIN",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-24",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.179824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bucyrus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.