Active NPI
Julian Brennan Licht
- Peer Specialist
- Saint Clairsville, OH
National Provider Identifier
1982479960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- APS.004150
- Practice address
- 68150 Bayberry Dr
Saint Clairsville, OH 43950-8547 - Phone
- (740) 996-7010
- NPI assigned
- Nov 20, 2023
- Last updated
- Nov 20, 2023
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | APS.004150 | OH | Primary |
Addresses
Primary practice location
68150 Bayberry Dr
Saint Clairsville, OH 43950-8547
Mailing address
5982 Rhodes Rd
Kent, OH 44240-8100
Phone (330) 673-1347
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 |
|---|---|---|---|
| APS.004150 | OH | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700438400000",
"number": "1982479960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5982 RHODES RD",
"city": "KENT",
"state": "OH",
"postal_code": "442408100",
"telephone_number": "330-673-1347",
"fax_number": "330-678-3677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68150 BAYBERRY DR",
"city": "SAINT CLAIRSVILLE",
"state": "OH",
"postal_code": "439508547",
"telephone_number": "740-996-7010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICHT",
"first_name": "JULIAN",
"middle_name": "BRENNAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-11-20",
"last_updated": "2023-11-20",
"certification_date": "2023-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OH",
"license": "APS.004150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Clairsville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.