Individual provider Active NPI

Freddie M Murry, LCDCIII

  • Addiction (Substance Use Disorder) Counselor
  • Dayton, OH
National Provider Identifier
1811536998
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
162427 Issued in OH
Practice address
1 Elizabeth PL
Dayton, OH 45417-3445
Phone
(937) 813-1737
NPI assigned
Jan 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.170180 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X 170180 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X 173086 OH
Addiction (Substance Use Disorder) Counselor 101YA0400X 162427 OH Primary

Addresses

Primary practice location

1 Elizabeth PL
Dayton, OH 45417-3445

Mailing address

1 Elizabeth PL
Dayton, OH 45417-3445

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
162427OHMDAddiction (Substance Use Disorder) Counselor
170180OHMDAddiction (Substance Use Disorder) Counselor
173086OHMDAddiction (Substance Use Disorder) Counselor
CDCA.170180OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Havens of Ohio LLC Past Accepting new patients

Organizations & group practices 1

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": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1811536998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454173445",
            "telephone_number": "937-813-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRY",
        "first_name": "FREDDIE",
        "middle_name": "M",
        "credential": "LCDCIII",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-06",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.170180",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "170180",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "173086",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "162427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.

Verify at the official NPI Registry.