MEDICARE: JODIE MCCAIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CDCA.188304	OH

General Provider Information

NPI Number	:	1053016238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODIE MCCAIN

Provider Business Mailing Address
First Line	:	1 ELIZABETH PL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-3445
Country	:	US
Telephone Number	:	937-813-1737
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 ELIZABETH PL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-3445
Country	:	US
Telephone Number	:	937-813-1737
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2023
Last Update Date	:	02/02/2026

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Directions to “ JODIE MCCAIN ” Practice Location

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