Individual provider Active NPI

Joseph Humphries, NCC, LSW, LPCC

  • Clinical Social Worker
  • Poland, OH
National Provider Identifier
1013994912
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S-0020095 Issued in OH
Practice address
3292 Stones Throw Ave
Poland, OH 44514-4213
Phone
(330) 757-3975
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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 S-0020095 OH Primary

Addresses

Primary practice location

3292 Stones Throw Ave
Poland, OH 44514-4213

Mailing address

8577 E Market St
Warren, OH 44484-2345
Phone (330) 856-6663

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
I20240106000543 OH Practitioner - Mental Health Counselor 2769706472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preferred Care Counseling LLCGroup PAC ID 7315261021, 8 clinicians

Practice addresses (Care Compare)

3292 Stones Throw Ave
Poland, OH 44514-4213
Phone (330) 757-3975

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-0020095OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Care Associates, LLC CurrentSince Feb 17, 2015 Accepting new patients
Preferred Care Counseling LLC Current Accepting new patients
Preferred Care Counseling LLC CurrentSince Apr 15, 2010 Accepting new patients
Preferred Care Partners LLC Clinical PastSince Feb 7, 2017 Accepting new patients

Locations

425 Niles Cortland Rd SE
Ste 201
Warren, OH 44484
Phone (330) 856-3795

3292 Stones Throw Ave
Youngstown, OH 44514
Phone (330) 707-0771

Organizations & group practices 4

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1013994912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8577 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842345",
            "telephone_number": "330-856-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3292 STONES THROW AVE",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445144213",
            "telephone_number": "330-757-3975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHRIES",
        "first_name": "JOSEPH",
        "credential": "NCC, LSW, LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S-0020095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

Verify at the official NPI Registry.