Active NPI
Miranda Erdman, LCDCIII
- Addiction (Substance Use Disorder) Counselor
- Maumee, OH
National Provider Identifier
1871075069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCDCIII.162274
- Practice address
- 1655 Holland Rd Ste F
Maumee, OH 43537-1656 - Phone
- (513) 834-7063
- NPI assigned
- Sep 4, 2018
- Sex
- Female
- Sole proprietor
- No
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 | CDCA.172621 | OH | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCDCIII.162274 | OH | Primary |
Addresses
Primary practice location
1655 Holland Rd Ste F
Maumee, OH 43537-1656
Mailing address
615 Elsinore PL Ste 200
Cincinnati, OH 45202-1457
Phone (513) 834-7063
Other practice location 1
4747 Monroe St
Toledo, OH 43623-4307
Phone (419) 740-5709
Other practice location 2
1201 Champlain St
Toledo, OH 43604-1907
Phone (419) 214-4316
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0323757 | Medicaid | OH |
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 |
|---|---|---|---|
| CDCA.172621 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| LCDCIII.162274 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649376000000",
"number": "1871075069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 ELSINORE PL STE 200",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452021457",
"telephone_number": "513-834-7063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1655 HOLLAND RD STE F",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435371656",
"telephone_number": "513-834-7063"
}
],
"practiceLocations": [
{
"address_1": "4747 Monroe St",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "436234307",
"country_code": "US",
"telephone_number": "419-740-5709",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1201 Champlain St",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "436041907",
"country_code": "US",
"telephone_number": "419-214-4316",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ERDMAN",
"first_name": "MIRANDA",
"credential": "LCDCIII",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-04",
"last_updated": "2022-04-08",
"certification_date": "2022-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.172621",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "LCDCIII.162274",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0323757",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maumee, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.