Individual provider Active NPI

Tanice A Prince, LISW-S

  • Clinical Social Worker
  • Delaware, OH
National Provider Identifier
1063052967
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2405586-SUPV Issued in OH
Practice address
175 S Sandusky St Ste 258
Delaware, OH 43015-2621
Phone
(614) 285-4144
NPI assigned
Jan 9, 2020
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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.2405586-SUPV OH Primary

Addresses

Primary practice location

175 S Sandusky St Ste 258
Delaware, OH 43015-2621

Mailing address

175 S Sandusky St Ste 258
Delaware, OH 43015-2621
Phone (614) 285-4144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OH, MI, TX4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20250516002786 IL Practitioner - Clinical Social Worker 5395263958 Reassigns benefits to 1 organization
I20250523002291 OH Practitioner - Clinical Social Worker 5395263958 Reassigns benefits to 1 organization
I20260318003801 MI Practitioner - Clinical Social Worker 5395263958 Reassigns benefits to 1 organization
I20260611004463 TX Practitioner - Clinical Social Worker 5395263958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.2405586-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Apr 9, 2025 Accepting new patients

Locations

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

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1063052967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 S SANDUSKY ST STE 258",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430152621",
            "telephone_number": "614-285-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S SANDUSKY ST STE 258",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430152621",
            "telephone_number": "614-285-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "TANICE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2405586-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delaware, OH

Sources for this page

Verify at the official NPI Registry.