Individual provider Active NPI

Samantha Stripe

  • Addiction (Substance Use Disorder) Counselor
  • Toledo, OH
National Provider Identifier
1669945549
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.167672 Issued in OH
Practice address
115 S Reynolds Rd Ste C
Toledo, OH 43615
Phone
(419) 725-6631
NPI assigned
Jan 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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 CDCA.167672 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.167672 OH Primary

Addresses

Primary practice location

115 S Reynolds Rd Ste C
Toledo, OH 43615

Mailing address

115 S Reynolds Rd Ste C
Toledo, OH 43615-6958
Phone (419) 725-6631

Other practice location 1

511 Perry St
Defiance, OH 43512-2123
Phone (419) 782-9920

Other practice location 2

511 Perry St
Defiance, OH 43512-2123
Phone (419) 782-9920

Other identifiers 1

IdentifierTypeStateIssuer
CDCA.167672OtherOHCDCA

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.167672OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Treatment Centers Oh-IX, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1669945549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S REYNOLDS RD STE C",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436156958",
            "telephone_number": "419-725-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S REYNOLDS RD STE C",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43615",
            "telephone_number": "419-725-6631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 Perry St",
            "address_purpose": "LOCATION",
            "city": "Defiance",
            "state": "OH",
            "postal_code": "435122123",
            "country_code": "US",
            "telephone_number": "419-782-9920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "511 Perry St",
            "address_purpose": "LOCATION",
            "city": "Defiance",
            "state": "OH",
            "postal_code": "435122123",
            "country_code": "US",
            "telephone_number": "419-782-9920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STRIPE",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": "CDCA.167672",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.167672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDCA",
            "identifier": "CDCA.167672",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.