Fostoria Alcohol/Drug Center

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1479 Issued in OH

Legal business name

FOSTORIA ALCOHOL/DRUG CENTER

Practice address

222 S Main St Ste B
Fostoria, OH 44830-2321

Phone

(419) 435-9465

Fax

(419) 435-0493

NPI assigned

Jun 11, 2014

Last updated

Jun 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Zimmerman, LICDC-CS/SAP/ICCS

Title

Executive Director

Phone

(419) 435-9465

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402444800000",
    "number": "1669885265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S MAIN ST STE B",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448302321",
            "telephone_number": "419-435-9465",
            "fax_number": "419-435-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S MAIN ST STE B",
            "city": "FOSTORIA",
            "state": "OH",
            "postal_code": "448302321",
            "telephone_number": "419-435-9465",
            "fax_number": "419-435-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOSTORIA ALCOHOL/DRUG CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-11",
        "last_updated": "2014-06-11",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "419-435-9465",
        "authorized_official_credential": "LICDC-CS/SAP/ICCS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "1479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Etter, OTD, OTR/L
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• Adam Wesley Flugga
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• Fostoria City Office of Auditor (Fostoria Fire Department)
• Fostoria City Schools
• Fostoria Community Hospital
• Fostoria Community Hospital
• Fostoria Community Hospital

• Addiction (Substance Use Disorder) Counselor in Fostoria, OH
• Providers in Fostoria, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; 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.