Individual provider Active NPI

Judith F Waldron, LCDCIII, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Portsmouth, OH
National Provider Identifier
1760985972
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCDCIII.162101 Issued in OH
Practice address
1405 11TH St
Portsmouth, OH 45662-4203
Phone
(513) 834-7063
Fax
(513) 873-1567
NPI assigned
Mar 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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 164479 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDCIII.162101 OH Primary

Addresses

Primary practice location

1405 11TH St
Portsmouth, OH 45662-4203

Mailing address

615 Elsinore PL Ste 200
Cincinnati, OH 45202-1459
Phone (513) 834-7063

Other practice location 1

500 Burlington Rd
Jackson, OH 45640-9360
Phone (740) 577-3492 ext. 9360

Other identifiers 1

IdentifierTypeStateIssuer
2864002MedicaidOH

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
164479OHMDAddiction (Substance Use Disorder) Counselor
LCDCIII.162101OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1760985972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ELSINORE PL STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021459",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 11TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456624203",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Burlington Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "OH",
            "postal_code": "456409360",
            "country_code": "US",
            "telephone_number": "740-577-3492 x9360",
            "fax_number": "740-577-3496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALDRON",
        "first_name": "JUDITH",
        "middle_name": "F",
        "credential": "LCDCIII, CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2025-09-12",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "164479",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII.162101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2864002",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.