Renee Ann Von Phelps, LCDC III

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCDCIII.161684 Issued in OH

Practice address

827 N Main St
Marion, OH 43302-1736

Phone

(740) 914-5000

Fax

(740) 914-5005

NPI assigned

May 14, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1710477955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 N MAIN ST",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433021736",
            "telephone_number": "740-914-5000",
            "fax_number": "740-914-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 N MAIN ST",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433021736",
            "telephone_number": "740-914-5000",
            "fax_number": "740-914-5005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Park Ave W",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449063706",
            "country_code": "US",
            "telephone_number": "419-528-5993 x115",
            "fax_number": "567-560-5483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VON PHELPS",
        "first_name": "RENEE",
        "middle_name": "ANN",
        "credential": "LCDC III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII.161684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0284130",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://d1recovery.com/",
            "affiliation": "N",
            "endpointDescription": "Employer website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "827 N Main St",
            "city": "Marion",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433021736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelsie Ann Vaske, CT
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• Megan Venturino
• Joann Virden, P.A.
• Voca Corporation of Ohio
• Nicole Louise Voorhies
• Sanjay K Vora, M.D.
• Michele Vucinich, D.M.D,
• Robert Lynn Waddell
• Brittany Wade-Tucker

• Addiction (Substance Use Disorder) Counselor in Marion, OH
• Providers in Marion, 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 Feb 3, 2021; 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.