Individual provider Active NPI

Patti Jo Fuentes, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Columbus, OH
National Provider Identifier
1831919505
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
CDCA.189733 Issued in OH
Practice address
5381 N High St
Columbus, OH 43214-1116
Phone
(380) 799-6061
Fax
(614) 396-9300
NPI assigned
Oct 16, 2024
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.189733 OH Primary

Addresses

Primary practice location

5381 N High St
Columbus, OH 43214-1116

Mailing address

7432 Basil Western Rd NW
Canal Winchester, OH 43110-9207
Phone (380) 799-6061

Other names 1

  • Angel Fuentes Other name

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
CDCA.189733OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
A Good Deed LLC CurrentSince Oct 20, 2024 Accepting new patients
A Good Deed LLC CurrentSince Oct 20, 2024 Accepting new patients

Locations

5381 N High St
Columbus, OH 43214
Phone (380) 799-6061

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": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1831919505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7432 BASIL WESTERN RD NW",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431109207",
            "telephone_number": "380-799-6061",
            "fax_number": "614-396-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5381 N HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141116",
            "telephone_number": "380-799-6061",
            "fax_number": "614-396-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "PATTI",
        "middle_name": "JO",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.189733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGEL",
            "last_name": "FUENTES",
            "credential": "CDCA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.