Individual provider Active NPI

Brianne J Tolley

  • Clinical Social Worker
  • Independence, OH
National Provider Identifier
1073863767
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1451332 Issued in OH
Practice address
5905 Brecksville Rd
Independence, OH 44131-1517
Phone
(216) 524-4673
NPI assigned
Sep 11, 2012
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X S1000412 OH
Clinical Social Worker 1041C0700X I.1451332 OH Primary

Addresses

Primary practice location

5905 Brecksville Rd
Independence, OH 44131-1517

Mailing address

202 E Bagley Rd
Berea, OH 44017-2058
Phone (800) 234-2006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S1000412OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone of Hope Inc Clinical CurrentSince Apr 15, 2021 Accepting new patients

Locations

5905 Brecksville Rd
Independence, OH 44131
Phone (216) 524-4673

Organizations & group practices 1

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": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1073863767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E BAGLEY RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440172058",
            "telephone_number": "800-234-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5905 BRECKSVILLE RD",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441311517",
            "telephone_number": "216-524-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLEY",
        "first_name": "BRIANNE",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "S1000412",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1451332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

Verify at the official NPI Registry.