Individual provider Active NPI

Lauren Czerniak, LISW

  • Clinical Social Worker
  • Toledo, OH
National Provider Identifier
1104374958
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2103102 Issued in OH
Practice address
4159 N Holland Sylvania Rd Ste 205
Toledo, OH 43623-4801
Phone
(614) 674-6076
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1600832 OH
Community/Behavioral Health Agency 251S00000X
Clinical Social Worker 1041C0700X I.2103102 OH Primary

Addresses

Primary practice location

4159 N Holland Sylvania Rd Ste 205
Toledo, OH 43623-4801

Mailing address

4159 N Holland Sylvania Rd Ste 205
Toledo, OH 43623-4801
Phone (614) 674-6076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1600832OHMDSocial Worker
I.2103102OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Renewed Mind Community/Behavioral Health 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.

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1104374958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4159 N HOLLAND SYLVANIA RD STE 205",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234801",
            "telephone_number": "614-674-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4159 N HOLLAND SYLVANIA RD STE 205",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234801",
            "telephone_number": "614-674-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZERNIAK",
        "first_name": "LAUREN",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1600832",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2103102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.