Individual provider Active NPI

Timothy Weitzel, LISW-S

  • Clinical Social Worker
  • Sandusky, OH
National Provider Identifier
1073054540
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1440295-SUPV Issued in OH
Practice address
501 Superior St
Sandusky, OH 44870-4487
Phone
(567) 304-3900
Fax
(567) 304-3902
NPI assigned
Mar 16, 2017
Last updated
Feb 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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.1440295-SUPV OH Primary

Addresses

Primary practice location

501 Superior St
Sandusky, OH 44870-4487

Mailing address

420 Superior St
Sandusky, OH 44870-1849
Phone (419) 626-5623

Other practice location 1

1250 Sanford St
Vermilion, OH 44089-1577
Phone (567) 867-5174

Other practice location 2

34 Executive Dr Ste A
Norwalk, OH 44857-2490
Phone (567) 867-5174

Other practice location 3

221 W Parish St
Sandusky, OH 44870-4877
Phone (567) 867-5215

Other practice location 4

316 Mason Rd W
Milan, OH 44846-9500
Phone (567) 867-5174

Other practice location 5

420 Superior St
Sandusky, OH 44870-1849
Phone (419) 626-5623

Other practice location 6

117 Addison St
Kelleys Island, OH 43438-6500
Phone (567) 867-5174

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
I20250116003578 OH Order and Referring Only - Clinical Social Worker 4880122944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1440295-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Erie County Office of Auditor CurrentSince Feb 23, 2025 Accepting new patients
Erie County Office of Auditor CurrentSince Feb 23, 2025 Accepting new patients
Erie County Office of Auditor Past Accepting new patients
Erie County Office of Auditor Past Accepting new patients

Locations

420 Superior St
Sandusky, OH 44870
Phone (567) 867-5215

Interoperability endpoints

  • Direct secure messaging: timothy.weitzellisws.p1@direct.ecchc.nextgenshare.com

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, 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": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1073054540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SUPERIOR ST",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448701849",
            "telephone_number": "419-626-5623",
            "fax_number": "419-626-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SUPERIOR ST",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704487",
            "telephone_number": "567-304-3900",
            "fax_number": "567-304-3902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 Sanford St",
            "address_purpose": "LOCATION",
            "city": "Vermilion",
            "state": "OH",
            "postal_code": "440891577",
            "country_code": "US",
            "telephone_number": "567-867-5174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "34 Executive Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "OH",
            "postal_code": "448572490",
            "country_code": "US",
            "telephone_number": "567-867-5174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "221 W Parish St",
            "address_purpose": "LOCATION",
            "city": "Sandusky",
            "state": "OH",
            "postal_code": "448704877",
            "country_code": "US",
            "telephone_number": "567-867-5215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "316 Mason Rd W",
            "address_purpose": "LOCATION",
            "city": "Milan",
            "state": "OH",
            "postal_code": "448469500",
            "country_code": "US",
            "telephone_number": "567-867-5174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "420 Superior St",
            "address_purpose": "LOCATION",
            "city": "Sandusky",
            "state": "OH",
            "postal_code": "448701849",
            "country_code": "US",
            "telephone_number": "419-626-5623",
            "fax_number": "419-626-8778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 Addison St",
            "address_purpose": "LOCATION",
            "city": "Kelleys Island",
            "state": "OH",
            "postal_code": "434386500",
            "country_code": "US",
            "telephone_number": "567-867-5174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEITZEL",
        "first_name": "TIMOTHY",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-16",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1440295-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.