Active NPI
Paula Rae Roberts, CDCA
- Peer Specialist
- Coventry Township, OH
National Provider Identifier
1851957443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- APS.003647
- Practice address
- 3445 S Main St
Coventry Township, OH 44319-3028 - Phone
- (330) 644-4095
- NPI assigned
- May 20, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 162867 | OH | |
| Peer Specialist | 175T00000X | APS.003647 | OH | Primary |
Addresses
Primary practice location
3445 S Main St
Coventry Township, OH 44319-3028
Mailing address
3445 S Main St
Coventry Township, OH 44319-3028
Phone (330) 644-4095
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
| License | State | Type | Specialty |
|---|---|---|---|
| 162867 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| APS.003647 | OH | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728604800000",
"number": "1851957443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3445 S MAIN ST",
"city": "COVENTRY TOWNSHIP",
"state": "OH",
"postal_code": "443193028",
"telephone_number": "330-644-4095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3445 S MAIN ST",
"city": "COVENTRY TOWNSHIP",
"state": "OH",
"postal_code": "443193028",
"telephone_number": "330-644-4095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "PAULA",
"middle_name": "RAE",
"credential": "CDCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-20",
"last_updated": "2024-10-11",
"certification_date": "2024-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "162867",
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OH",
"license": "APS.003647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coventry Township, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.