Timothy Ray Beverly, CDCA
NPI 1194211409ActiveIndividual· Counselor, Addiction (Substance Use Disorder)· Fairborn, OH
Counselor, Addiction (Substance Use Disorder) (CDCA) in Fairborn, Ohio, licensed in OH, with an NPI issued in July 2018.
Overview
| NPI | 1194211409 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CDCA |
| Sole proprietor | No |
| NPI issued | Jul 10, 2018 |
| Last updated in NPPES | Jan 25, 2024 |
| Certified by provider | Jan 25, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Addiction (Substance Use Disorder) Primary | 101YA0400X | LCDCII.161829 | OH |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 070488 | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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