Individual provider Active NPI

Sharnelle Hampton-Holiday, MSSA, LSW

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1093265050
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.1600926 Issued in OH
Practice address
4937 W Broad St Ste 205
Columbus, OH 43228-1646
Phone
(614) 681-1460
NPI assigned
Oct 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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 S.1600926 OH Primary

Addresses

Primary practice location

4937 W Broad St Ste 205
Columbus, OH 43228-1646

Mailing address

4937 W Broad St Ste 205
Columbus, OH 43228-1646

Other practice location 1

3737 Lander Rd
Pepper Pike, OH 44124-5712
Phone (216) 381-2255 ext. 2279

Other identifiers 1

IdentifierTypeStateIssuer
2871101MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.1600926OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1093265050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4937 W BROAD ST STE 205",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4937 W BROAD ST STE 205",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281646",
            "telephone_number": "614-681-1460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3737 Lander Rd",
            "address_purpose": "LOCATION",
            "city": "Pepper Pike",
            "state": "OH",
            "postal_code": "441245712",
            "country_code": "US",
            "telephone_number": "216-381-2255 x2279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMPTON-HOLIDAY",
        "first_name": "SHARNELLE",
        "credential": "MSSA, LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1600926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2871101",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.