Individual provider Active NPI

Joel R Sutton, PH.D., P.C.C.

  • Professional Counselor
  • Perrysburg, OH
National Provider Identifier
1790102119
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0003037 Issued in OH
Practice address
1070 Commerce Dr Ste 101
Perrysburg, OH 43551-5231
Phone
(419) 482-8382
NPI assigned
Mar 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X E0003037 OH
Professional Counselor 101YP2500X E.0003037 OH Primary

Addresses

Primary practice location

1070 Commerce Dr Ste 101
Perrysburg, OH 43551-5231

Mailing address

6950 Independence Rd
Defiance, OH 43512-9030
Phone (567) 444-4825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240503003015 OH Practitioner - Mental Health Counselor 2860832094 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
E0003037OHMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Institute of America CurrentSince Feb 18, 2024 Accepting new patients
Unison Behavioral Health Group, Inc. CurrentSince Apr 2, 2024 Accepting new patients
Premiere Counseling Services, LLC Professional CurrentSince Oct 13, 2024 Accepting new patients
Unison Behavioral Health Group, Inc Past Accepting new patients

Locations

1070 Commerce Dr
Ste 101
Perrysburg, OH 43551
Phone (419) 461-1983

1425 Starr Ave
Toledo, OH 43605
Phone (419) 259-4506

544 E Woodruff Ave
Toledo, OH 43604
Phone (419) 214-4673

Organizations & group practices 4

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": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1790102119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 INDEPENDENCE RD",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435129030",
            "telephone_number": "567-444-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 COMMERCE DR STE 101",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435515231",
            "telephone_number": "419-482-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "JOEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D., P.C.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-24",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "E0003037",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0003037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.