Mychal Deeb, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.1303243 Issued in OH

Practice address

2775 State Route 39
Shelby, OH 44875-9466

Phone

(419) 747-3322

Fax

(419) 747-3504

NPI assigned

Mar 13, 2017

Last updated

Mar 13, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Cornell Abraxas Group, LLC

  dba Abraxas Counseling Center

  • Children's Substance Abuse Rehabilitation Facility
  • Shelby, OH
  • NPI 1134385669
  NPD (past)
• Cornell Abraxas Group, LLC

  • Children's Substance Abuse Rehabilitation Facility
  • Shelby, OH
  • NPI 1376518902
  NPD (past)

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

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1053852855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 STATE ROUTE 39",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448759466",
            "telephone_number": "419-747-3322",
            "fax_number": "419-747-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 STATE ROUTE 39",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448759466",
            "telephone_number": "419-747-3322",
            "fax_number": "419-747-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEEB",
        "first_name": "MYCHAL",
        "name_prefix": "Miss",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1303243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Jean Davies, LPN
• Dawn Davis
• Kristofer Isaac Davis
• Michelle Day, CPHT
• Jennifer Lynn Dean, LPN
• Tyler Robert Deisher, CDCA
• Hannah Marie Delong
• Marion C Demers, M.D.
• Harrison Dewalt, LSW
• Jonathan Dewalt

• Social Worker in Shelby, OH
• Providers in Shelby, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.