Individual provider Active NPI

Jessica Alain Richards, LISW

  • Clinical Social Worker
  • Sandusky, OH
National Provider Identifier
1033449897
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I 1101067 Issued in OH
Practice address
1925 Hayes Ave
Sandusky, OH 44870-4737
Phone
(419) 557-5177
Fax
(419) 557-5179
NPI assigned
Dec 30, 2009
Last updated
Mar 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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 1101067 OH Primary

Addresses

Primary practice location

1925 Hayes Ave
Sandusky, OH 44870-4737

Mailing address

675 Bartson Rd
Fremont, OH 43420-9672
Phone (419) 332-5524

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
I20120516000258 OH Practitioner - Clinical Social Worker 6901069699 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I 1101067OHMDClinical Social Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1262131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1033449897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 BARTSON RD",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434209672",
            "telephone_number": "419-332-5524",
            "fax_number": "419-332-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704737",
            "telephone_number": "419-557-5177",
            "fax_number": "419-557-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "JESSICA",
        "middle_name": "ALAIN",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-30",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 1101067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.