Active NPI
James Derosa, LISW
- Clinical Social Worker
- Toledo, OH
National Provider Identifier
1104033562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I 7195
- Practice address
- 3454 Oak Alley CT
Suite 305
Toledo, OH 43606-1306 - Phone
- (419) 534-2468
- NPI assigned
- May 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I 7195 | OH | Primary |
Addresses
Primary practice location
3454 Oak Alley CT
Suite 305
Toledo, OH 43606-1306
Mailing address
3454 Oak Alley CT
Suite 305
Toledo, OH 43606-1306
Phone (419) 534-2468
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I 7195 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Drescher and Associates Clinical Services, LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Psychologist
- Maumee, OH
- NPI 1558837294
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104033562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3454 OAK ALLEY CT",
"address_2": "SUITE 305",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436061306",
"telephone_number": "419-534-2468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3454 OAK ALLEY CT",
"address_2": "SUITE 305",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436061306",
"telephone_number": "419-534-2468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROSA",
"first_name": "JAMES",
"name_prefix": "Mr.",
"credential": "LISW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I 7195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.