Individual provider Active NPI

Anne Mallett, LISW-S

  • Clinical Social Worker
  • Defiance, OH
National Provider Identifier
1083809271
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0800121-S Issued in OH
Practice address
201 E 2ND St
Defiance, OH 43512-2290
Phone
(440) 260-8300
Fax
(440) 260-8575
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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.0800121-S OH Primary

Addresses

Primary practice location

201 E 2ND St
Defiance, OH 43512-2290

Mailing address

434 Eastland Rd
Berea, OH 44017-1217
Phone (440) 260-8300

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
I20100623000850 OH Practitioner - Clinical Social Worker 8022149897 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 MC Donald Pike
Paulding, OH 45879-9239
Phone (419) 238-3434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0800121-SOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone CurrentSince Sep 3, 2021 Accepting new patients
Ohioguidestone CurrentSince Sep 3, 2021 Accepting new patients
Ohioguidestone Current Accepting new patients
Harbor Clinical CurrentSince Oct 7, 2022 Accepting new patients
Westwood Behavioral Health Center, Inc. Current Accepting new patients
Maumee Valley Guidance Center Inc. CurrentSince Jul 9, 2010 Accepting new patients
Westwood Behavioral Health Center, Inc. CurrentSince May 1, 2024 Accepting new patients
Harbor PastSince Oct 7, 2022 Accepting new patients

Locations

434 Eastland Rd
Berea, OH 44017
Phone (440) 260-8327

202 E Bagley Rd
Berea, OH 44017
Phone (440) 260-8327

1010 N Prospect St
Bowling Green, OH 43402
Phone (419) 352-5249

211 Biede Ave
Defiance, OH 43512
Phone (419) 782-8856

201 E 2nd St
Defiance, OH 43512
Phone (419) 359-0336

101 Clinton St
Defiance, OH 43512
Phone (419) 782-4196

501 Mc Donald Pike
Paulding, OH 45879
Phone (419) 238-3434

123 22nd St
Toledo, OH 43604
Phone (419) 241-6191

3909 Woodley Rd
Toledo, OH 43606
Phone (419) 725-3330

1158 Westwood Dr
Van Wert, OH 45891
Phone (419) 238-3434

Organizations & group practices 8

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": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1083809271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171217",
            "telephone_number": "440-260-8300",
            "fax_number": "440-260-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 2ND ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122290",
            "telephone_number": "440-260-8300",
            "fax_number": "440-260-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLETT",
        "first_name": "ANNE",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0800121-S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Defiance, OH

Sources for this page

Verify at the official NPI Registry.