Individual provider Active NPI

Daniel J Eble, MED, PCC

  • Professional Counselor
  • Toledo, OH
National Provider Identifier
1790829356
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E0003550 Issued in OH
Practice address
3130 Executive Pkwy FL 8
Toledo, OH 43606-5530
Phone
(419) 720-9000
Fax
(419) 720-9002
NPI assigned
Feb 16, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E0003550 OH Primary

Addresses

Primary practice location

3130 Executive Pkwy FL 8
Toledo, OH 43606-5530

Mailing address

3130 Executive Pkwy FL 8
Toledo, OH 43606-5530
Phone (419) 720-9000

Other identifiers 1

IdentifierTypeStateIssuer
E0003550OtherOHCOUNSELOR LICENSE

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)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
E0003550OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Diana L Theiss PHD Past Accepting new patients
Valmoor LLC PastSince Jan 21, 2004 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790829356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 EXECUTIVE PKWY FL 8",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436065530",
            "telephone_number": "419-720-9000",
            "fax_number": "419-720-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 EXECUTIVE PKWY FL 8",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436065530",
            "telephone_number": "419-720-9000",
            "fax_number": "419-720-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBLE",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MED, PCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E0003550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNSELOR LICENSE",
            "identifier": "E0003550",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.