Active NPI
Mario Santino Bugnone, LISW
- Clinical Social Worker
- North Bend, OR
National Provider Identifier
1043753916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.2102756
- Practice address
- 2136 Ash St
North Bend, OR 97459-2118 - Phone
- (928) 380-1120
- NPI assigned
- Nov 28, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I.2102756 | OH | Primary |
| Social Worker | 104100000X | I.2102756 | OH |
Addresses
Primary practice location
2136 Ash St
North Bend, OR 97459-2118
Mailing address
2136 Ash St
North Bend, OR 97459-2118
Phone (928) 380-1120
Other practice location 1
7440 Liberty Rd
Solon, OH 44139-5606
Phone (928) 380-1120
Other practice location 2
2916 Central Ave
Cleveland, OH 44115-3229
Phone (216) 535-9100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0383084 | Medicaid | OH |
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.2102756 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752019200000",
"number": "1043753916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2136 ASH ST",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974592118",
"telephone_number": "928-380-1120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2136 ASH ST",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974592118",
"telephone_number": "928-380-1120"
}
],
"practiceLocations": [
{
"address_1": "7440 Liberty Rd",
"address_purpose": "LOCATION",
"city": "Solon",
"state": "OH",
"postal_code": "441395606",
"country_code": "US",
"telephone_number": "928-380-1120",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2916 Central Ave",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "441153229",
"country_code": "US",
"telephone_number": "216-535-9100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUGNONE",
"first_name": "MARIO",
"middle_name": "SANTINO",
"credential": "LISW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-11-28",
"last_updated": "2025-07-09",
"certification_date": "2025-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.2102756",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "I.2102756",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0383084",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.