LICKING COUNTY ALCOHOLISM PREVENTION PROGRAM
NPI 1124089438
Counselor - Addiction (Substance Use Disorder) in Newark, OH

Q: What is Licking County Alcoholism Prevention Program's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Active since March 29, 2006

62 E STEVENS ST, NEWARK, OH 43055(740) 366-7303(740) 366-7305 Get Directions Write a Review

NPPES record last updated: February 21, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Licking County Alcoholism Prevention Program NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LICKING COUNTY ALCOHOLISM PREVENTION PROGRAM (NPI 1124089438) is a healthcare organization registered as an addiction (substance use disorder) in Newark, Ohio and active in the NPI registry since March 2006. The organization maintains a secondary practice location in Pataskala and lists John Jordan, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1124089438

Entity TypeOrganization

Primary Taxonomy101YA0400X

Legal Business NameLICKING COUNTY ALCOHOLISM PREVENTION PROGRAM

Location Address62 E STEVENS STNewark, OH 43055-5969

Mailing Address62 E Stevens StNewark, OH 43055-5969 · (740) 366-7303 · Fax (740) 366-7305

Phone(740) 366-7303

Fax(740) 366-7305

Organization SubpartNo

Authorized OfficialJohn JordanExecutive Director · (740) 403-9494

Enumeration DateMarch 29, 2006

Last NPPES UpdateFebruary 21, 2024

NPPES CertifiedFebruary 21, 2024

✔ NPI 1124089438 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in OH · 01322

62 E STEVENS ST, Newark, OH 43055

Open in Google Maps ↗

Secondary Practice Location 1

Location 1621 Broad St SWPataskala, OH 43062-8118 · Phone (740) 366-7303

Other Identifiers 2

Other01322OH · Odadas

Medicaid45-579-01OH

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Licking County Alcoholism Prevention Program is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 4 clinicians reassign Medicare billing to Licking County Alcoholism Prevention Program, which bills Medicare for the services they deliver. Of these, 4 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Richard Sharp, LPCC-S, LICDC

Mental Health Counselor

NPI 1306927868

62 E STEVENS ST
Newark, OH 43055

(740) 366-7303

✔ PECOS✔ Accepts Medicare0.3 mi

Deborah Esterline, LISW

Clinical Social Worker

NPI 1780038653

62 E STEVENS ST
Newark, OH 43055

(740) 364-7254

✔ PECOS✔ Accepts Medicare0.3 mi

Tristan Kettel, CDCA

Licdc

NPI 1750081832

62 E STEVENS ST
Newark, OH 43055

(740) 366-7303

✔ PECOS0.3 mi

Julia Warner, MSW, LSW

Mental Health Counselor

NPI 1861115222

62 E STEVENS ST
Newark, OH 43055

(740) 366-7303

✔ PECOS✔ Accepts Medicare0.3 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Licking County Alcoholism Prevention Program's NPI number?

The NPI number for Licking County Alcoholism Prevention Program is 1124089438. It was assigned to this organization in the NPPES registry on March 29, 2006.

Where is Licking County Alcoholism Prevention Program located?

Licking County Alcoholism Prevention Program is located at 62 E Stevens St, Newark, OH 43055. The listed phone number is (740) 366-7303.

What is Licking County Alcoholism Prevention Program's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Licking County Alcoholism Prevention Program enrolled in Medicare?

Yes. Licking County Alcoholism Prevention Program is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Licking County Alcoholism Prevention Program?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Licking County Alcoholism Prevention Program, in Clinical Social Worker, Licdc and Mental Health Counselor. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 4 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Licking County Alcoholism Prevention Program accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Licking County Alcoholism Prevention Program as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Licking County Alcoholism Prevention Program was last updated on February 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.