Individual provider Active NPI

Marrenda Gambill, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Austintown, OH
National Provider Identifier
1861249401
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
188145 Issued in OH
Practice address
4501 Deer Creek CT Apt 12
Austintown, OH 44515-5418
Phone
(724) 734-0334
NPI assigned
May 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 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 188145 OH Primary

Addresses

Primary practice location

4501 Deer Creek CT Apt 12
Austintown, OH 44515-5418

Mailing address

4501 Deer Creek CT Apt 12
Austintown, OH 44515-5418
Phone (724) 734-0334

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
188145OHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1861249401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 DEER CREEK CT APT 12",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445155418",
            "telephone_number": "724-734-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 DEER CREEK CT APT 12",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445155418",
            "telephone_number": "724-734-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBILL",
        "first_name": "MARRENDA",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "188145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austintown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.