Hallie L Gustin, LISW-S – School Social Worker

Key facts

NPI: 1114379765
Entity type: Individual (NPI type 1)
Primary specialty: School Social Worker 1041S0200X
License: I.0009098-SUPV (OH)
Practice address: 14201 Southington Rd
Shaker HTS, OH 44120-2703
Phone: (216) 751-8453
Fax: (216) 361-2340
NPI assigned: Jul 7, 2016
Sex: Female
Sole proprietor: No

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.

Positive Education Program Emotionally Disturbed Childrens' Residential Treatment Facility · Cleveland, OH · NPI 1528035631

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
I.0009098-SUPV	OH	MD	School Social Worker

Practice roles

Organization	Specialty	Status	New patients
Positive Education Program		Past	Accepting new patients

Interoperability endpoints

FHIR API: https://api.qualifacts.org/api/fhir/pepcleve/r4/

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
School Social Worker	1041S0200X	I.0009098-SUPV	OH	Yes

Addresses

Primary practice location

14201 Southington Rd
Shaker HTS, OH 44120-2703

Mailing address

3100 Euclid Ave
Cleveland, OH 44115-2508
Phone (216) 361-4400

Other providers in Shaker HTS, OH

All providers in Shaker HTS, OH · School Social Worker in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2016. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.