Individual provider Active NPI

Carson Ashby Wassermann, MSW, LSW

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1124168984
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0700391 Issued in OH
Practice address
2330 Victory Pkwy
Ste. 500
Cincinnati, OH 45206-2839
Phone
(513) 221-2330
Fax
(513) 221-8954
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X S0500668 OH
Clinical Social Worker 1041C0700X I0700391 OH Primary

Addresses

Primary practice location

2330 Victory Pkwy
Ste. 500
Cincinnati, OH 45206-2839

Mailing address

2330 Victory Pkwy
Ste. 500
Cincinnati, OH 45206-2839
Phone (513) 221-2330

Other identifiers 1

IdentifierTypeStateIssuer
0057455MedicaidOH

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
S0500668OHMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1124168984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 VICTORY PKWY",
            "address_2": "STE. 500",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452062839",
            "telephone_number": "513-221-2330",
            "fax_number": "513-221-8954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 VICTORY PKWY",
            "address_2": "STE. 500",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452062839",
            "telephone_number": "513-221-2330",
            "fax_number": "513-221-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMANN",
        "first_name": "CARSON",
        "middle_name": "ASHBY",
        "name_prefix": "Ms.",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "S0500668",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0700391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0057455",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.