Healthcare Provider Details

I. General information

NPI: 1043957301
Provider Name (Legal Business Name): WINFORD RICHARD STURGILL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 COURT ST
PORTSMOUTH OH
45662-3932
US

IV. Provider business mailing address

4304 OLD SCIOTO TRL
PORTSMOUTH OH
45662-6672
US

V. Phone/Fax

Practice location:
  • Phone: 740-354-6685
  • Fax: 740-876-4005
Mailing address:
  • Phone: 740-351-9298
  • Fax: 740-351-9298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLICDC.162756
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCDCIII.162608
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2507000
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: