Individual provider Active NPI

Theresa Cluse-Tolar, LISW-S, PH.D.

  • Clinical Social Worker
  • Toledo, OH
National Provider Identifier
1053658203
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I 00004585-SUPV Issued in OH
Practice address
3000 Arlington Ave
Ms 1161
Toledo, OH 43614-2595
Phone
(419) 530-4397
Fax
(419) 530-4141
NPI assigned
Jan 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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 00004585-SUPV OH Primary

Addresses

Primary practice location

3000 Arlington Ave
Ms 1161
Toledo, OH 43614-2595

Mailing address

3000 Arlington Ave
Ms 1161
Toledo, OH 43614-2595
Phone (419) 530-4397

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
I 00004585-SUPVOHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1053658203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE",
            "address_2": "MS 1161",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142595",
            "telephone_number": "419-530-4397",
            "fax_number": "419-530-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ARLINGTON AVE",
            "address_2": "MS 1161",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142595",
            "telephone_number": "419-530-4397",
            "fax_number": "419-530-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUSE-TOLAR",
        "first_name": "THERESA",
        "credential": "LISW-S, PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-08",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 00004585-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.