Gillyan Baccus

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.169595 Issued in OH

Practice address

4124 Linden Ave
Dayton, OH 45432-3018

Phone

(937) 522-0961

NPI assigned

Sep 3, 2019

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cornerstone Project, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dayton, OH
  • NPI 1639609548
  NPD

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1891343885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 PIMLICO PL",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454243883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4124 LINDEN AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454323018",
            "telephone_number": "937-522-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCUS",
        "first_name": "GILLYAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.169595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO CHEMICAL DEPENDENCY BOARD",
            "identifier": "CDCA.169595",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarkis Babikian, M.D.
• Bac Medical LLC
• Camille Baccus
• Carmen Baccus
• Gerald Lee Baccus
• Kurt Bachman, QMHS/CMS
• Jonathan H Bachna, PHARMD
• Maria Bachna, PA-C
• Kristy Bachnivsky
• Back in Motion Durable Medical Equipment LLC

• Addiction (Substance Use Disorder) Counselor in Dayton, OH
• Providers in Dayton, 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 Sep 3, 2019; 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.