Individual provider Active NPI

Ameleah Tyler, MSW, LISW-S

  • Clinical Social Worker
  • Wooster, OH
National Provider Identifier
1083014419
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.21002779 Issued in OH
Practice address
2285 Benden Dr
Wooster, OH 44691-2568
Phone
(330) 264-9029
Fax
(330) 263-7251
NPI assigned
Sep 4, 2014
Last updated
Aug 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.2102779-SUPV OH
Clinical Social Worker 1041C0700X I.21002779 OH Primary

Addresses

Primary practice location

2285 Benden Dr
Wooster, OH 44691-2568

Mailing address

2587 Back Orrville Rd
Wooster, OH 44691-9523
Phone (330) 264-9597

Other practice location 1

3011 Akron Rd
Wooster, OH 44691
Phone (330) 264-3232 ext. 3905

Other practice location 2

2587 Back Orrville Rd
Wooster, OH 44691-9523
Phone (330) 264-9597

Other identifiers 2

IdentifierTypeStateIssuer
1083014419MedicaidOH
8857MedicaidOH

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
I20251113001082 OH Practitioner - Clinical Social Worker 9133610504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anazao Community PartnersGroup PAC ID 6406345636, 4 clinicians

Practice addresses (Care Compare)

2587 Back Orrville Rd
Wooster, OH 44691-9523
Phone (330) 264-9597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.21002779OHMDClinical Social Worker
I.2102779-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anazao Community Partners CurrentSince Oct 25, 2025 Accepting new patients
Anazao Community Partners PastSince Apr 25, 2021 Accepting new patients

Locations

2587 Back Orrville Rd
Wooster, OH 44691
Phone (330) 264-9597

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, 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": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1083014419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2587 BACK ORRVILLE RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446919523",
            "telephone_number": "330-264-9597",
            "fax_number": "330-264-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 BENDEN DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912568",
            "telephone_number": "330-264-9029",
            "fax_number": "330-263-7251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3011 Akron Rd",
            "address_purpose": "LOCATION",
            "city": "Wooster",
            "state": "OH",
            "postal_code": "44691",
            "country_code": "US",
            "telephone_number": "330-264-3232 x3905",
            "fax_number": "330-202-3879",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2587 Back Orrville Rd",
            "address_purpose": "LOCATION",
            "city": "Wooster",
            "state": "OH",
            "postal_code": "446919523",
            "country_code": "US",
            "telephone_number": "330-264-9597",
            "fax_number": "330-264-0946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYLER",
        "first_name": "AMELEAH",
        "name_prefix": "Mrs.",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2102779-SUPV",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.21002779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083014419",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8857",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.