Individual provider Active NPI

Andrea L Goehring, LISW

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1003067042
Registry record updated Jun 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-0800128 Issued in OH
Practice address
1555 Bethel Rd
Columbus, OH 43220-2003
Phone
(614) 442-0664
Fax
(614) 442-0620
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-0800128 OH Primary

Addresses

Primary practice location

1555 Bethel Rd
Columbus, OH 43220-2003

Mailing address

1555 Bethel Rd
Columbus, OH 43220-2003
Phone (614) 442-0664

Other names 1

  • Andrea L. Roeble Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-0800128OHMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1003067042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 BETHEL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202003",
            "telephone_number": "614-442-0664",
            "fax_number": "614-442-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 BETHEL RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202003",
            "telephone_number": "614-442-0664",
            "fax_number": "614-442-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEHRING",
        "first_name": "ANDREA",
        "middle_name": "L",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0800128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "ROEBLE",
            "middle_name": "L.",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.