Individual provider Active NPI

Jade Berry, LISW

  • Clinical Social Worker
  • Beachwood, OH
National Provider Identifier
1104467273
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2203662 Issued in OH
Practice address
23215 Commerce Park
Beachwood, OH 44122-5803
Phone
(216) 244-7350
NPI assigned
Sep 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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 I.2203662 OH Primary

Addresses

Primary practice location

23215 Commerce Park
Beachwood, OH 44122-5803

Mailing address

23215 Commerce Park
Beachwood, OH 44122-5803
Phone (216) 244-7350

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL jade.berry@empoweringics.com

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

LicenseStateTypeSpecialty
I.2203662OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psycho Social Therapies,LTD Clinical PastSince Dec 10, 2023 Accepting new patients
Empowering Integrated Care Solutions, LLC Past Accepting new patients
Empowering Integrated Care Solutions, LLC Past Accepting new patients

Organizations & group practices 3

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": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1104467273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23215 COMMERCE PARK",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225803",
            "telephone_number": "216-244-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23215 COMMERCE PARK",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225803",
            "telephone_number": "216-244-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JADE",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2203662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jade.berry@empoweringics.com",
            "affiliation": "N",
            "address_1": "23215 Commerce Park Ste 306",
            "city": "Beachwood",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441225843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.