Kathleen Saxer-Tisdale, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.0003132 Issued in OH

Practice address

5255 N Abbe Rd
Suite 1
Sheffield Village, OH 44035-1451

Phone

(440) 934-9930

Fax

(440) 934-9645

NPI assigned

Jul 18, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1063430908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 E 22ND ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153202",
            "telephone_number": "216-459-9827",
            "fax_number": "216-696-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 N ABBE RD",
            "address_2": "SUITE 1",
            "city": "SHEFFIELD VILLAGE",
            "state": "OH",
            "postal_code": "440351451",
            "telephone_number": "440-934-9930",
            "fax_number": "440-934-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAXER-TISDALE",
        "first_name": "KATHLEEN",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.0003132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS PIN",
            "identifier": "000000124718",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Sheffield Village, OH
• Providers in Sheffield Village, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.