Joan Leslie Odonoghue, LICDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

83976 Issued in OH

Practice address

7265 Old Oak Blvd
Middleburg Heights, OH 44130-3342

Phone

(440) 816-8200

Fax

(440) 816-8197

NPI assigned

Jul 29, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1861623522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PEARL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441303615",
            "telephone_number": "440-816-8200",
            "fax_number": "440-816-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7265 OLD OAK BLVD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303342",
            "telephone_number": "440-816-8200",
            "fax_number": "440-816-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONOGHUE",
        "first_name": "JOAN",
        "middle_name": "LESLIE",
        "credential": "LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-29",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "83976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Middleburg Heights, OH
• Providers in Middleburg Heights, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.