Individual provider Active NPI

Melissa Marie Heidemann, LISW-S

  • Social Worker
  • Painesville, OH
National Provider Identifier
1003194903
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
L.1100197-SUPV Issued in OH
Practice address
1848 Thornwood LN
Painesville, OH 44077-6151
Phone
(440) 423-5933
NPI assigned
Jul 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X L.1100197-SUPV OH Primary

Addresses

Primary practice location

1848 Thornwood LN
Painesville, OH 44077-6151

Mailing address

1848 Thornwood LN
Painesville, OH 44077-6151
Phone (440) 423-5933

Other practice location 1

525 Metro Pl N Ste 300
Dublin, OH 43017-5320
Phone (855) 289-1722

Other identifiers 1

IdentifierTypeStateIssuer
2910854MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250613002126 OH Practitioner - Clinical Social Worker 3476064742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Viaquest Psychiatric and Behavioral Solutions LLCGroup PAC ID 1153358486, 118 clinicians

Practice addresses (Care Compare)

525 Metro PL N
Suite 300
Dublin, OH 43017-5320
Phone (855) 289-1722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L.1100197-SUPVOHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Viaquest Psychiatric & Behavioral Solutions LLC CurrentSince May 19, 2025 Accepting new patients
Viaquest Psychiatric & Behavioral Solutions LLC CurrentSince May 19, 2025 Accepting new patients

Locations

525 Metro Pl N
Ste 300
Dublin, OH 43017
Phone (614) 336-9600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1003194903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 THORNWOOD LN",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440776151",
            "telephone_number": "440-423-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 THORNWOOD LN",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440776151",
            "telephone_number": "440-423-5933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Metro Pl N Ste 300",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "OH",
            "postal_code": "430175320",
            "country_code": "US",
            "telephone_number": "855-289-1722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIDEMANN",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-26",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "L.1100197-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Painesville, OH

Sources for this page

Verify at the official NPI Registry.