Individual provider Active NPI

Mariella Smith, CDCA

  • Case Manager/Care Coordinator
  • Dublin, OH
National Provider Identifier
1679086540
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
525 Metro PL N Ste 100
Dublin, OH 43017-5343
Phone
(855) 289-1722
NPI assigned
Nov 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.166744 OH
Case Manager/Care Coordinator 171M00000X OH Primary

Addresses

Primary practice location

525 Metro PL N Ste 100
Dublin, OH 43017-5343

Mailing address

525 Metro PL N Ste 100
Dublin, OH 43017-5343
Phone (855) 289-1722

Other practice location 1

550 W Chalmers Ave
Youngstown, OH 44511-1576
Phone (330) 797-0070

Other practice location 2

527 N Meridian Rd
Youngstown, OH 44509-1227
Phone (330) 797-0070

Other identifiers 1

IdentifierTypeStateIssuer
2910854MedicaidOH

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.166744OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1679086540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175343",
            "telephone_number": "855-289-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175343",
            "telephone_number": "855-289-1722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 W Chalmers Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445111576",
            "country_code": "US",
            "telephone_number": "330-797-0070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "527 N Meridian Rd",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445091227",
            "country_code": "US",
            "telephone_number": "330-797-0070",
            "fax_number": "330-797-9146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARIELLA",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.166744",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.