Individual provider Active NPI

Terra Ulrich-Hiple

  • Social Worker
  • Canton, OH
National Provider Identifier
1063989598
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I.1901732 Issued in OH
Practice address
100 30TH St NW Ste 104
Canton, OH 44709-3100
Phone
(330) 493-4553
NPI assigned
Nov 2, 2018
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I.1901732 OH Primary

Addresses

Primary practice location

100 30TH St NW Ste 104
Canton, OH 44709-3100

Mailing address

100 30TH St NW Ste 104
Canton, OH 44709-3100

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
I20191025000639 OH Practitioner - Clinical Social Worker 4183956063 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Affirmation Counseling LLC CurrentSince Oct 1, 2023 Accepting new patients
Phoenix Rising Behavioral Healthcare and Recovery, Inc CurrentSince Oct 7, 2019 Accepting new patients
Phoenix Rising Behavioral Healthcare and Recovery Inc CurrentSince Oct 7, 2019 Accepting new patients

Locations

100 30th St NW
Ste 104
Canton, OH 44709
Phone (330) 407-5749

624 Market Ave N
Canton, OH 44702
Phone (330) 454-7066

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, 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": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1063989598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 30TH ST NW STE 104",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447093100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 30TH ST NW STE 104",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447093100",
            "telephone_number": "330-493-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULRICH-HIPLE",
        "first_name": "TERRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-02",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.1901732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.