Individual provider Active NPI

Roxalana Landon, LCDC III

  • Addiction (Substance Use Disorder) Counselor
  • Mentor, OH
National Provider Identifier
1649920695
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
162636 Issued in OH
Practice address
9083 Mentor Ave
Mentor, OH 44060-6462
Phone
(440) 255-0678
Fax
(440) 255-6348
NPI assigned
Mar 24, 2022
Last updated
Feb 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X 002799 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X 162636 OH Primary

Addresses

Primary practice location

9083 Mentor Ave
Mentor, OH 44060-6462

Mailing address

9083 Mentor Ave
Mentor, OH 44060-6462
Phone (440) 255-0678

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
162636OHMDAddiction (Substance Use Disorder) Counselor
002799OHMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1649920695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9083 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606462",
            "telephone_number": "440-255-0678",
            "fax_number": "440-255-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9083 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440606462",
            "telephone_number": "440-255-0678",
            "fax_number": "440-255-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDON",
        "first_name": "ROXALANA",
        "credential": "LCDC III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "002799",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "162636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.