Individual provider Active NPI

Dornice Ivanna Friday, MSW, LW

  • Clinical Social Worker
  • Willoughby, OH
National Provider Identifier
1053941195
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.1502313 Issued in OH
Practice address
36000 Euclid Ave
Willoughby, OH 44094-4625
Phone
(440) 953-9600
NPI assigned
Jan 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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 S.1502313 OH Primary

Addresses

Primary practice location

36000 Euclid Ave
Willoughby, OH 44094-4625

Mailing address

998 Marietta Dr
Painesville, OH 44077-2704
Phone (330) 348-4524

Other practice location 1

7590 Auburn Rd
Painesville, OH 44077-9176
Phone (440) 375-8100

Electronic endpoints 3

TypeEndpointUseAffiliation
Other URL DorFriday Health Information Exchange (HIE)
CONNECT URL dornice.friday@hushmail.com Direct
CONNECT URL ivannafriday@gmail.com Direct

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
I20230927003091 OH Practitioner - Clinical Social Worker 1254785033 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1502313OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Sep 13, 2023 Accepting new patients
Iscream Social LLC Current Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Sep 6, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

Interoperability endpoints

  • Direct secure messaging: dornice.friday.1@23610.direct.athenahealth.com

Organizations & group practices 3

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": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1053941195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 MARIETTA DR",
            "city": "PAINESVILLE",
            "state": "OH",
            "postal_code": "440772704",
            "telephone_number": "330-348-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 EUCLID AVE",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944625",
            "telephone_number": "440-953-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7590 Auburn Rd",
            "address_purpose": "LOCATION",
            "city": "Painesville",
            "state": "OH",
            "postal_code": "440779176",
            "country_code": "US",
            "telephone_number": "440-375-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIDAY",
        "first_name": "DORNICE",
        "middle_name": "IVANNA",
        "credential": "MSW, LW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1502313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "DorFriday",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "36000 Euclid Ave",
            "city": "Willoughby",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440944625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dornice.friday@hushmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "36000 Euclid Ave",
            "city": "Willoughby",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440944625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ivannafriday@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7590 Auburn Rd",
            "city": "Painesville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440779176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

Verify at the official NPI Registry.