Jerad Minic, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2304673 Issued in OH

Practice address

195 Union St
Newark, OH 43055-3919

Phone

(740) 485-8005

NPI assigned

Jun 4, 2019

Last updated

Aug 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/isaoh/r4/

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

• Integrated Services for Behavioral Health

  • Clinical Social Worker
  • Nelsonville, OH
  • NPI 1073578431
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, OH

  Medicare reassignment NPD
• Dirty Talk Counseling and Consultation LLC

  • Mental Health Counselor
  • Canton, OH
  • NPI 1174452403
  Authorized official Same address or phone
• Integrated Services for Behavioral Health

  • Community/Behavioral Health Agency
  • Nelsonville, OH
  • NPI 1205196201
  NPD (past)

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1023676186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "796 MANCHESTER CT",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431472079",
            "telephone_number": "937-441-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 UNION ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430553919",
            "telephone_number": "740-485-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINIC",
        "first_name": "JERAD",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1903607",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2304673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0352324",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sally Ann Miller, PT
• Shelby Jane Miller
• Suzette Monique Millhorn-Goddard
• Stefanie Rose Milmeister, SOCIAL WORK TRAINEE
• Minesh Patel DDS LLC
• Jodi K Minor
• Minuteclinic Diagnostic of Ohio LLC
• Zeyn T. Mirza
• Joyce Peterson Misel, O.D.
• Curt A Misko, MD

• Clinical Social Worker in Newark, OH
• Providers in Newark, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.