Individual provider Active NPI

Marianna Lynn Zdinak, LPCC-S

  • Professional Counselor
  • Blue Ash, OH
National Provider Identifier
1831605849
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.2102119 Issued in OH
Practice address
10200 Alliance Rd Ste 150
Blue Ash, OH 45242-4754
Phone
(513) 891-0650
Fax
(513) 891-2838
NPI assigned
Dec 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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 LICDC.162265 OH
Professional Counselor 101YP2500X E.2102119 OH Primary

Addresses

Primary practice location

10200 Alliance Rd Ste 150
Blue Ash, OH 45242-4754

Mailing address

10200 Alliance Rd Ste 150
Blue Ash, OH 45242-4754
Phone (513) 891-0650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: No
  • 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
I20240224000114 OH Practitioner - Mental Health Counselor 0345685806 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICDC.162265OHMDAddiction (Substance Use Disorder) Counselor
E.2102119OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Psychiatry & Wellness, LLC CurrentSince Jan 11, 2024 Accepting new patients
Modern Psychiatry and Wellness LLC CurrentSince Jan 11, 2024 Accepting new patients
Psychological & Behavioral Consultants, LLC CurrentSince Jul 8, 2024 Accepting new patients
Beaumont Behavioral Health PSC Past Accepting new patients

Locations

2900 Presidential Dr
Ste 100
Beavercreek, OH 45324
Phone (513) 741-3100

10200 Alliance Rd
Ste 150
Blue Ash, OH 45242
Phone (513) 563-0488

1910 Fairgrove Ave
Ste E
Hamilton, OH 45011
Phone (513) 299-4025

25111 Country Club Blvd
Ste 290
North Olmsted, OH 44070
Phone (440) 614-2520

6942 Tylersville Rd
West Chester, OH 45069
Phone (513) 795-7557

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.qualifacts.org/api/fhir/mpwhealth/r4/

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": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1831605849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 ALLIANCE RD STE 150",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452424754",
            "telephone_number": "513-891-0650",
            "fax_number": "513-891-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 ALLIANCE RD STE 150",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452424754",
            "telephone_number": "513-891-0650",
            "fax_number": "513-891-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZDINAK",
        "first_name": "MARIANNA",
        "middle_name": "LYNN",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-28",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162265",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2102119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ash, OH

Sources for this page

Verify at the official NPI Registry.