Active NPI
Andrew W Nolen, MCJ/FP, CDCA
- Addiction (Substance Use Disorder) Counselor
- Mansfield, OH
National Provider Identifier
1912472549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.120357
- Practice address
- 151 Marion Ave
Mansfield, OH 44903 - Phone
- (419) 774-9969
- NPI assigned
- Oct 10, 2018
- Last updated
- Feb 15, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.120357 | OH | Primary |
Addresses
Primary practice location
151 Marion Ave
Mansfield, OH 44903
Mailing address
538 S Union St
Galion, OH 44833-2548
Phone (740) 751-3881
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.120357 | 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": "1539129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550188800000",
"number": "1912472549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "538 S UNION ST",
"city": "GALION",
"state": "OH",
"postal_code": "448332548",
"telephone_number": "740-751-3881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 MARION AVE",
"city": "MANSFIELD",
"state": "OH",
"postal_code": "44903",
"telephone_number": "419-774-9969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLEN",
"first_name": "ANDREW",
"middle_name": "W",
"credential": "MCJ/FP, CDCA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-10-10",
"last_updated": "2019-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.120357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mansfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.