Individual provider Active NPI

Michael Hall McGrady, LISW, LICDC

  • Clinical Social Worker
  • Mount Gilead, OH
National Provider Identifier
1073882478
Registry record updated Sep 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I. 1303280 Issued in OH
Practice address
950 Meadow Dr
Suite a
Mount Gilead, OH 43338-1389
Phone
(419) 947-4560
NPI assigned
Dec 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 081199 OH
Clinical Social Worker 1041C0700X I. 1303280 OH Primary

Addresses

Primary practice location

950 Meadow Dr
Suite a
Mount Gilead, OH 43338-1389

Mailing address

471 State Route 100
Bucyrus, OH 44820-9543
Phone (419) 985-5293

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
I20131120001632 OH Practitioner - Clinical Social Worker 0941436083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Wellness Counseling Solutions LLCGroup PAC ID 0648580928, 3 clinicians

Practice addresses (Care Compare)

102 S Sandusky Ave
Upper Sandusky, OH 43351-1424
Phone (419) 294-1212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
081199OHMDAddiction (Substance Use Disorder) Counselor
I. 1303280OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Counseling Solutions, LLC Addiction (Substance Use Disorder) CurrentSince Apr 1, 2016 Accepting new patients
Wellness Counseling Solutions, LLC Clinical CurrentSince Feb 27, 2022 Accepting new patients
Family Life Counseling & Psyciatric Services Addiction (Substance Use Disorder) PastSince May 5, 2015 Accepting new patients

Locations

102 S Sandusky Ave
Upper Sandusky, OH 43351
Phone (419) 294-1212

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380153600000",
    "number": "1073882478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 STATE ROUTE 100",
            "city": "BUCYRUS",
            "state": "OH",
            "postal_code": "448209543",
            "telephone_number": "419-985-5293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 MEADOW DR",
            "address_2": "SUITE A",
            "city": "MOUNT GILEAD",
            "state": "OH",
            "postal_code": "433381389",
            "telephone_number": "419-947-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRADY",
        "first_name": "MICHAEL",
        "middle_name": "HALL",
        "credential": "LISW, LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-14",
        "last_updated": "2013-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "081199",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I. 1303280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Gilead, OH

Sources for this page

Verify at the official NPI Registry.