Individual provider Active NPI

Marisol Sedore, MSW, LISW

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1073863759
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4770 Indianola Ave # 107
Columbus, OH 43214-1862
Phone
(614) 371-2303
Fax
(800) 905-9950
NPI assigned
Sep 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 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 Primary

Addresses

Primary practice location

4770 Indianola Ave # 107
Columbus, OH 43214-1862

Mailing address

4770 Indianola Ave # 107
Columbus, OH 43214-1862
Phone (614) 371-2303

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
I20250318000588 OH Practitioner - Clinical Social Worker 0345762563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holistic Wellness Solutions LLCGroup PAC ID 6002243755, 10 clinicians

Practice addresses (Care Compare)

4770 Indianola Ave
Suite 107
Columbus, OH 43214-1862
Phone (614) 371-2303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Wellness Solutions LLC Clinical CurrentSince Jan 9, 2025 Accepting new patients
Holistic Wellness Solutions LLC Clinical CurrentSince Jan 9, 2025 Accepting new patients

Locations

4770 Indianola Ave
Ste 107
Columbus, OH 43214
Phone (614) 371-2303

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1073863759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 INDIANOLA AVE # 107",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141862",
            "telephone_number": "614-371-2303",
            "fax_number": "800-905-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 INDIANOLA AVE # 107",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141862",
            "telephone_number": "614-371-2303",
            "fax_number": "800-905-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDORE",
        "first_name": "MARISOL",
        "credential": "MSW, LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.