Tiffany A Fishbaugh, LISW-S
Individual provider Active NPI Social Worker · Celina, OH
NPI 1104177575 · NPPES record last updated Mar 24, 2024
Key facts
- NPI
- 1104177575
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- I0009286 SUPV (OH)
- Practice address
- 7095 Emerson Rd
Celina, OH 45822-2946 - Phone
- (567) 644-2028
- NPI assigned
- Sep 26, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Momentum Counseling and Consultation, LLC
Practice addresses (Care Compare)
112 /2 N Main St
Celina, OH 45822-1729
Phone (419) 584-5123
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150814013727 | OH | Practitioner - Clinical Social Worker | 8527373885 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I0009286 SUPV | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Personal Wellness, LLC | Past | Accepting new patients | |
| Center for Personal Wellness, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | I0009286 SUPV | OH | Yes |
Addresses
Primary practice location
7095 Emerson Rd
Celina, OH 45822-2946
Mailing address
7095 Emerson Rd
Celina, OH 45822-2946
Phone (567) 644-2028
Other names
- Tiffany A Hamilton
Other providers in Celina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.