Individual provider Active NPI

Desiree J Farragher, MSW, LISW-S

  • Clinical Social Worker
  • Youngstown, OH
National Provider Identifier
1063713428
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1302458-SUPV Issued in OH
Practice address
2980 Belmont Ave
Youngstown, OH 44505-1834
Phone
(330) 759-2310
Fax
(330) 759-0018
NPI assigned
Nov 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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.1302458-SUPV OH Primary

Addresses

Primary practice location

2980 Belmont Ave
Youngstown, OH 44505-1834

Mailing address

2980 Belmont Ave
Youngstown, OH 44505-1834
Phone (330) 759-2310

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
I20130610000418 OH Practitioner - Clinical Social Worker 1153560875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psy-Care, Inc.Group PAC ID 9335136795, 29 clinicians

Practice addresses (Care Compare)

136 Westchester Dr
Suite 5
Austintown, OH 44515-3965
Phone (330) 270-1400

2980 Belmont Ave
Youngstown, OH 44505-1834
Phone (330) 759-2310

Merit-based Incentive Payment System (MIPS)

Final score
41.34 of 100Reported as group
Quality
20.12
Improvement activities
0
Cost
84.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1302458-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psy-Care Inc Clinical Current Accepting new patients
Psycare, Inc. CurrentSince May 14, 2013 Accepting new patients
Psycare Inc CurrentSince May 14, 2013 Accepting new patients
Psycare Inc Past Accepting new patients

Locations

107 Javit Ct
Ste B
Austintown, OH 44515
Phone (330) 270-1400

15549 State Route 170
Ste 10
East Liverpool, OH 43920
Phone (330) 385-1000

2980 Belmont Ave
Youngstown, OH 44505
Phone (330) 759-0276

Organizations & group practices 4

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": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1063713428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051834",
            "telephone_number": "330-759-2310",
            "fax_number": "330-759-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051834",
            "telephone_number": "330-759-2310",
            "fax_number": "330-759-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRAGHER",
        "first_name": "DESIREE",
        "middle_name": "J",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-16",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1302458-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.