Individual provider Active NPI

Cody McMillan, LPCC-S

  • Mental Health Counselor
  • Dublin, OH
National Provider Identifier
1669066171
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.1800907 Issued in OH
Practice address
179 Monterey Dr
Dublin, OH 43017-1328
Phone
(133) 077-0690
NPI assigned
Feb 24, 2021
Last updated
Feb 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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 E.1800907 OH Primary

Addresses

Primary practice location

179 Monterey Dr
Dublin, OH 43017-1328

Mailing address

179 Monterey Dr
Dublin, OH 43017-1328
Phone (133) 077-0690

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
I20240214000287 OH Practitioner - Mental Health Counselor 7214371640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Churchill Counseling Services, Inc.Group PAC ID 3779532262, 17 clinicians

Practice addresses (Care Compare)

3649 Canfield Rd
Suite 8
Canfield, OH 44406-9385
Phone (330) 270-3040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.1800907OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Churchill Counseling Services, Inc Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Trumbull Mahoning Medical Group, Inc. PastSince Jan 1, 2024 Accepting new patients

Locations

3649 Canfield Rd
Ste 8
Canfield, OH 44406
Phone (330) 270-3040

4531 Belmont Ave
Ste 8
Youngstown, OH 44505
Phone (330) 759-0099

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, 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": "1614124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1669066171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 MONTEREY DR",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430171328",
            "telephone_number": "133-077-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 MONTEREY DR",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430171328",
            "telephone_number": "133-077-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "CODY",
        "name_prefix": "Mr.",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-24",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.1800907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.