AMANDA ODEH LPCC
NPI 1649784778
Counselor - Mental Health in Toledo, OH

NPI Status: Active since November 28, 2017

Contact Information

2005 ASHLAND AVE
TOLEDO, OH
ZIP 43620
Phone: (419) 841-7701

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  • Individual
  • Female
  • Years of Experience 8
  • Counselor
  • Mental Health
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About AMANDA ODEH

This page provides the complete NPI Profile along with additional information for Amanda Odeh, a provider established in Toledo, Ohio with a medical specialization in Counselor, focusing in mental health and more than 8 years of experience. The healthcare provider is registered in the NPI registry with number 1649784778 assigned on November 2017. The practitioner's primary taxonomy code is 101YM0800X with license number E.2203029 (OH). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI
1649784778
Provider Name
AMANDA ODEH LPCC
Gender
Female
Entity Type
Individual
Location Address
2005 ASHLAND AVE TOLEDO, OH 43620
Location Phone
(419) 841-7701
Mailing Address
2005 ASHLAND AVE TOLEDO, OH 43620
Mailing Phone
(419) 841-7701
Medical School Name
OTHER
Graduation Year
2018
Is Sole Proprietor?
No
Enumeration Date
11-28-2017
Last Update Date
08-01-2022
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A mental health counselor like Amanda Odeh provides treatment to individuals, families, couples, and groups for mental and emotional health issues and relationship problems. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses.

Location Map

Secondary Locations

  • 6605 W Central Ave
    Toledo, OH 43617
    (419) 841-7701
  • 905 Nebraska Ave
    Toledo, OH 43607
    (419) 841-7701

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Counselor Mental Health

Taxonomy Code
101YM0800X
Type
Behavioral Health & Social Service Providers
License No.
E.2203029
License State
OH

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision - HMO
  • Clear Silver - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
  • Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Essential 9200 (+ Incentives) - HMO
  • Anthem Bronze Essential 9200 Adult Dental/Vision (+ Incentives) - HMO
  • Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Pathway HMO 7450 for HSA - HMO
  • Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Catastrophic Pathway HMO 9200 - HMO
  • Anthem Gold Essential 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Essential 2200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Pathway HMO 1500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Bronze Pathway HMO 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Heart Healthy Bronze Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Heart Healthy Silver Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Heart Healthy Silver Pathway X HMO 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
  • Anthem Silver Essential 3500 HSA (+ Incentives) - HMO
  • Anthem Silver Essential 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Standard - HMO
  • Catastrophic Standard - HMO
  • Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Standard - HMO
  • Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Standard - HMO
  • Bronze First 7500 $25 Generic Drugs - HMO
  • Bronze First 7500 $25 Generic Drugs Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs Adult Vision & Fitness - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Gold 1100 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services - HMO
  • Diabetes Silver 4000 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Gold 1500 $15 Generic Drugs - HMO
  • Gold 1500 $15 Generic Drugs Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Select Drugs - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Gold 1500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services - HMO
  • Healthy Heart Silver 4500 $0 Select Drugs & Specialized Services Adult Vision & Fitness - HMO
  • Low Premium Silver 6000 $3 Generic Drugs - HMO
  • Low Premium Silver 6000 $3 Generic Drugs Adult Vision & Fitness - HMO
  • Silver 5000 $20 Generic Drugs - HMO
  • Silver 5000 $20 Generic Drugs Adult Vision & Fitness - HMO
  • Bronze First - HMO
  • Bronze First Adult Vision & Fitness - HMO
  • Diabetes Gold - HMO
  • Diabetes Gold Adult Vision & Fitness - HMO
  • Diabetes Silver - HMO
  • Diabetes Silver Adult Vision & Fitness - HMO
  • Gold - HMO
  • Gold Adult Vision & Fitness - HMO
  • HDHP Preventive Silver - HMO
  • Healthy Heart Gold - HMO
  • Healthy Heart Gold Adult Vision & Fitness - HMO
  • Healthy Heart Silver - HMO
  • Healthy Heart Silver Adult Vision & Fitness - HMO
  • Low Premium Silver - HMO
  • Low Premium Silver Adult Vision & Fitness - HMO
  • Silver - HMO
  • Silver Adult Vision & Fitness - HMO
  • MHP Bronze - HMO
  • MHP Bronze Saver (Expanded) - HMO
  • MHP Expanded Bronze Standard - HMO
  • MHP Gold - HMO
  • MHP Gold Standard - HMO
  • MHP Silver Exchange - HMO
  • MHP Silver Exchange Rewards - HMO
  • MHP Silver Standard - HMO
  • MHP Young Adult/Catastrophic - HMO
  • Bronze $8,300 w/ Virtual & Wellness ON-EX - HMO
  • Bronze HSA $7,300 ON-EX - HMO
  • Bronze Standard w/ Virtual & Wellness - HMO
  • Gold $1250 w/ Virtual & Wellness ON-EX - HMO
  • Gold $500 w/ Virtual & Wellness ON-EX - HMO
  • Gold Standard w/ Virtual & Wellness - HMO
  • Silver $5000 w/ Virtual & Wellness ON-EX - HMO
  • Silver Standard w/ Virtual & Wellness - HMO
  • SilverSelect w/ Virtual & Wellness ON-EX - HMO
  • Young Adult Essentials ON-EX - HMO
  • Bronze 10 - HMO
  • Bronze 8 - HMO
  • Bronze 9 - HMO
  • Gold 1 - HMO
  • Gold 1 with Adult Vision Services - HMO
  • Gold 8 - HMO
  • Silver 1 - HMO
  • Silver 1 with Adult Vision Services - HMO
  • Silver 12 with first 4 free PCP or MH visits - HMO
  • Silver 8 - HMO
  • Bronze Classic 4700 (Select) - HMO
  • Bronze Classic PCP Saver (Select) - HMO
  • Bronze Classic Standard (Select) - HMO
  • Gold Classic (Select) - HMO
  • Gold Classic Standard (Select) - HMO
  • Gold Elite Saver Plus (Select) - HMO
  • Secure (Select) - HMO
  • Silver Classic Standard (Select) - HMO
  • Silver Elite Saver Plus (Select) - HMO
  • Silver Simple Chronic Care CKM (Select) - HMO
  • Silver Simple PCP Saver (Select) - HMO
  • Bronze Classic PCP Saver - HMO
  • Bronze Classic Standard - HMO
  • Bronze Simple HSA - HMO
  • Gold Classic Standard - HMO
  • Gold Elite - HMO
  • Gold Elite Saver Plus - HMO
  • Secure - HMO
  • Silver Classic Standard - HMO
  • Silver Elite Saver Plus - HMO
  • Silver Simple Chronic Care CKM - HMO
  • Silver Simple Diabetes - HMO
  • Silver Simple PCP Saver - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - HMO
  • UHC Bronze Value ($5 Tier 2 Rx, No Referrals) - HMO
  • UHC Bronze Value+ ($5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Advantage ($3 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Gold Standard+ (Dental + Vision, No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Silver Standard (No Referrals) - HMO
  • UHC Silver Standard+ (Dental + Vision, No Referrals) - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Amanda Odeh is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Amanda Odeh is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 1557704335

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20240208002182

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): No

  • Eligible to Order or Refer Power Mobility Devices: No

Reviews for AMANDA ODEH LPCC

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1649784778
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
26891488714
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 8 + 9 + 1 + 4 + 8 + 8 + 7 + 1 + 4 + 24 = 82
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
90 - 82 = 88

The NPI number 1649784778 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1659579126MRS. TRACY MICHELLE BUESCHER LPTA
Individual
Physical Therapy Assistant2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 255-3040
1396975595MRS. BETH LYNN TREMSKY M.A.CCC/SLP-L
Individual
Speech-Language Pathologist2005 ASHLAND AVE LIBERTY NURSING CENTER
TOLEDO, OH 43620
(419) 255-3040
1750511895MRS. KARIE LYNN SUTTON COTA/L
Individual
Occupational Therapy Assistant2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 255-3040
1285864249 LINDA MILLER YORK OTR/L
Individual
Occupational Therapist2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 255-3040
1144546060MRS. CHANDRA EMILY COTTON-ARMSTRONG SR. LPN
Individual
Licensed Practical Nurse2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 255-3040
1982093431MR. JAMES FRANCIS STOVER II LICDC-CS
Individual
Counselor (Addiction (Substance Use Disorder))2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1922457548 JOSHUA AARON LINCYCOMB LPN
Individual
Licensed Practical Nurse2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-1450
1760831762MS. JENNIFER SUE TUCKER LSW
Individual
Social Worker2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1962869479 JAMES HOWARD PERRIN LICDC-CS
Individual
Counselor (Addiction (Substance Use Disorder))2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1811423759 NORINE WASIELEWSKI
Individual
Registered Nurse (Administrator)2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1386171940 TIFFANY RENEE SPENCER LPN
Individual
Licensed Practical Nurse2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1629594908 MELANIE LAMB LSW
Individual
Social Worker2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1649797036 ALEXANDRA CARDENAS
Individual
Social Worker2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1124531207MS. KYA COLLINS CDCA II
Individual
Social Worker (Clinical)2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1417460353 MATTHEW JOSEPH BRUNSMAN LSW, LCDCIII
Individual
Social Worker2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1992218804 KRISTINA LYNN EWING CDCA
Individual
Social Worker (Clinical)2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1396258232 KELLY MARIE GRAHAM BA, CDCA, MSCJ
Individual
Counselor (Addiction (Substance Use Disorder))2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1841703766 VERONICA THIELEN BA,CDCA
Individual
Social Worker2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1922511849 AMANDA LANIGAN MBA, MCJ, LSW
Individual
Social Worker2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701
1639682479MRS. KRYSTAL KAREEM HUGHES LSW
Individual
Social Worker2005 ASHLAND AVE
TOLEDO, OH 43620
(419) 841-7701

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1649784778, enumerated in the NPI registry as an "individual" on November 28, 2017

The provider is located at 2005 Ashland Ave Toledo, Oh 43620 and the phone number is (419) 841-7701

The provider's speciality is Counselor with taxonomy code 101YM0800X with a focus in Mental Health

The provider has more than 8 years of experience.

The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Meridian, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).

This NPI record was last updated on November 28, 2017. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.