Active NPI
Mary Theresa Massie, MSW LISW-S
- Clinical Social Worker
- Columbus, OH
National Provider Identifier
1043578487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.0005567 SUPV
- Practice address
- 1170 Old Henderson Rd
Suite 100
Columbus, OH 43220-3623 - Phone
- (614) 442-7650
- Fax
- (614) 442-7656
- NPI assigned
- Apr 23, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I.0005567 SUPV | OH | Primary |
Addresses
Primary practice location
1170 Old Henderson Rd
Suite 100
Columbus, OH 43220-3623
Mailing address
1170 Old Henderson Rd
Suite 100
Columbus, OH 43220-3623
Phone (614) 442-7650
Other names 1
- Mary Theresa Ritchey
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I.0005567 SUPV | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spirit of Peace Clinical Counseling | Clinical | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348531200000",
"number": "1043578487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1170 OLD HENDERSON RD",
"address_2": "SUITE 100",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432203623",
"telephone_number": "614-442-7650",
"fax_number": "614-442-7656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1170 OLD HENDERSON RD",
"address_2": "SUITE 100",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432203623",
"telephone_number": "614-442-7650",
"fax_number": "614-442-7656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSIE",
"first_name": "MARY",
"middle_name": "THERESA",
"credential": "MSW LISW-S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-23",
"last_updated": "2012-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.0005567 SUPV",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "RITCHEY",
"middle_name": "THERESA",
"credential": "MSW LISW-S",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.