Active NPI
Marc Osipchak, L.I.S.W-S
- Clinical Social Worker
- Cleveland, OH
National Provider Identifier
1124143284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I-0009452
- Practice address
- 3737 Lander Rd
Cleveland, OH 44124-5712 - Phone
- (216) 831-2255
- Fax
- (216) 378-4525
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I-0009452 | OH | Primary |
Addresses
Primary practice location
3737 Lander Rd
Cleveland, OH 44124-5712
Mailing address
16297 Heather LN
Cleveland, OH 44130-2575
Phone (440) 465-0145
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0268768 | Medicaid | OH |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-0009452 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297728000000",
"number": "1124143284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16297 HEATHER LN",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441302575",
"telephone_number": "440-465-0145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3737 LANDER RD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441245712",
"telephone_number": "216-831-2255",
"fax_number": "216-378-4525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSIPCHAK",
"first_name": "MARC",
"credential": "L.I.S.W-S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2011-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I-0009452",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0268768",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.