Active NPI
Tabitha M Braxton, CDCA
- Addiction (Substance Use Disorder) Counselor
- Mount Vernon, OH
National Provider Identifier
1982170999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.169786
- Practice address
- 213 E Chestnut St
Mount Vernon, OH 43050-3404 - Phone
- (740) 326-9255
- NPI assigned
- Oct 17, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.169786 | OH | Primary |
Addresses
Primary practice location
213 E Chestnut St
Mount Vernon, OH 43050-3404
Mailing address
213 E Chestnut St
Mount Vernon, OH 43050-3404
Phone (740) 326-9255
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.169786 | 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": "1539734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551225600000",
"number": "1982170999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 E CHESTNUT ST",
"city": "MOUNT VERNON",
"state": "OH",
"postal_code": "430503404",
"telephone_number": "740-326-9255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 E CHESTNUT ST",
"city": "MOUNT VERNON",
"state": "OH",
"postal_code": "430503404",
"telephone_number": "740-326-9255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAXTON",
"first_name": "TABITHA",
"middle_name": "M",
"credential": "CDCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-17",
"last_updated": "2019-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.169786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.