Active NPI
Maranda Kellerman, CDCA
- Addiction (Substance Use Disorder) Counselor
- Hamilton, OH
National Provider Identifier
1699428276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.177754
- Practice address
- 3621 Rossgate CT
Hamilton, OH 45013-9558 - Phone
- (513) 738-7600
- Fax
- (513) 738-7601
- NPI assigned
- Feb 2, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.177754 | OH | Primary |
Addresses
Primary practice location
3621 Rossgate CT
Hamilton, OH 45013-9558
Mailing address
3621 Rossgate CT
Hamilton, OH 45013-9558
Phone (513) 738-7600
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
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.177754 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643760000000",
"number": "1699428276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 ROSSGATE CT",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450139558",
"telephone_number": "513-738-7600",
"fax_number": "513-738-7601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3621 ROSSGATE CT",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450139558",
"telephone_number": "513-738-7600",
"fax_number": "513-738-7601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLERMAN",
"first_name": "MARANDA",
"credential": "CDCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-02",
"last_updated": "2022-02-02",
"certification_date": "2022-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.177754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamilton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.