Individual provider Active NPI

Dawn Rife

  • Clinical Social Worker
  • Madison, OH
National Provider Identifier
1104373968
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I2203475 Issued in OH
Practice address
15 W Main St
Madison, OH 44057-3125
Phone
(440) 428-0118
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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 I2203475 OH Primary

Addresses

Primary practice location

15 W Main St
Madison, OH 44057-3125

Mailing address

15 W Main St
Madison, OH 44057-3125
Phone (440) 428-0118

Other identifiers 1

IdentifierTypeStateIssuer
0299624MedicaidOH

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
I20221024001818 OH Practitioner - Clinical Social Worker 4284000894 Reassigns benefits to 1 organization
Practice locations: Madison, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I2203475OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC Clinical CurrentSince Jan 6, 2025 Accepting new patients
Dixon Family Counseling, Inc PastSince Oct 15, 2023 Accepting new patients

Locations

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

9500 Mentor Ave
Ste 220
Mentor, OH 44060
Phone (440) 357-7100

25111 Country Club Blvd
Ste 290
North Olmsted, OH 44070
Phone (440) 614-2520

34900 Chardon Rd
Ste 200
Willoughby Hills, OH 44094
Phone (440) 951-5600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1104373968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 W MAIN ST",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440573125",
            "telephone_number": "440-428-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 W MAIN ST",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440573125",
            "telephone_number": "440-428-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIFE",
        "first_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I2203475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0299624",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, OH

Sources for this page

Verify at the official NPI Registry.