Medella Counseling Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MEDELLA COUNSELING SERVICES LLC

Practice address

7700 State Route 42 S
Mansfield, OH 44904-9401

Phone

(740) 398-7431

NPI assigned

Aug 18, 2022

Organization subpart

No

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

Authorized official

Name

Jerry D HartmanNPI 1184811127

Title

Director

Phone

(740) 398-7431

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Medella Counseling Services Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerry Douglas Hartman

  • Clinical Social Worker
  • Mount Vernon, OH
  • NPI 1184811127

  Clinical, OH

  Medicare reassignment NPD Authorized official
• Melissa Berkshire

  • Case Manager/Care Coordinator
  • Mansfield, OH
  • NPI 1255911301
  NPD (past)
• Deborah Mitchell, MSW

  • Clinical Social Worker
  • Shelby, OH
  • NPI 1548611072

  Clinical

  NPD (past)

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1003534843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 STATE ROUTE 42 S",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449049401",
            "telephone_number": "740-398-7431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 STATE ROUTE 42 S",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449049401",
            "telephone_number": "740-398-7431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDELLA COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "HARTMAN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "740-398-7431"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0166847",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0166326",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Oracle",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7700 State Route 42 S",
            "city": "Mansfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "449049401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Medella Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Mansfield, OH
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.