Active NPI
Brad S Dieter, LPCC
- Professional Counselor
- Toledo, OH
National Provider Identifier
1962986455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E.2102532
- Practice address
- 1425 Starr Ave
Toledo, OH 43605-2456 - Phone
- (419) 936-7600
- Fax
- (419) 936-7606
- NPI assigned
- Sep 20, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Professional Counselor | 101YP2500X | E.2102532 | OH | Primary |
Addresses
Primary practice location
1425 Starr Ave
Toledo, OH 43605-2456
Mailing address
1425 Starr Ave
Toledo, OH 43605-2456
Phone (419) 936-7600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0315253 | 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 |
|---|---|---|---|
| E.2102532 | OH | MD | Professional Counselor |
Interoperability endpoints
- brad.dieter@iushc.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636502400000",
"number": "1962986455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1425 STARR AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436052456",
"telephone_number": "419-936-7600",
"fax_number": "419-936-7606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 STARR AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436052456",
"telephone_number": "419-936-7600",
"fax_number": "419-936-7606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETER",
"first_name": "BRAD",
"middle_name": "S",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-20",
"last_updated": "2021-11-10",
"certification_date": "2021-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.2102532",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0315253",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.