Individual provider Active NPI

Lauren Olivia Rohal, LISW-S

  • Clinical Social Worker
  • Medina, OH
National Provider Identifier
1124490883
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1901918-SUPV Issued in OH
Practice address
246 Northland Dr Ste 200a
Medina, OH 44256-3440
Phone
(330) 725-9195
Fax
(330) 725-9187
NPI assigned
Oct 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 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.1510299-TRNE OH
Clinical Social Worker 1041C0700X I.1901918 OH
Clinical Social Worker 1041C0700X I.1901918-SUPV OH Primary

Addresses

Primary practice location

246 Northland Dr Ste 200a
Medina, OH 44256-3440

Mailing address

246 Northland Dr Ste 200a
Medina, OH 44256-3440
Phone (330) 725-9195

Other practice location 1

18660 Bagley Rd Ste 404
Cleveland, OH 44130-3483
Phone (440) 234-8746

Other identifiers 2

IdentifierTypeStateIssuer
I.1901918OtherOHSTATE LICENSE NUMBER
I.1901918-SUPVOtherOHSOCIAL WORKER

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

LicenseStateTypeSpecialty
S.1510299-TRNEOHMDSocial Worker
I.1901918OHMDClinical Social Worker
I.1901918-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Florence Kimbo M.D., LLC Clinical CurrentSince Jan 1, 2020 Accepting new patients

Locations

18660 Bagley Rd
Ste 404
Middleburg Heights, OH 44130
Phone (440) 234-8746

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": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1124490883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 NORTHLAND DR STE 200A",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442563440",
            "telephone_number": "330-725-9195",
            "fax_number": "330-725-9187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 NORTHLAND DR STE 200A",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442563440",
            "telephone_number": "330-725-9195",
            "fax_number": "330-725-9187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18660 Bagley Rd Ste 404",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441303483",
            "country_code": "US",
            "telephone_number": "440-234-8746",
            "fax_number": "440-234-8748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROHAL",
        "first_name": "LAUREN",
        "middle_name": "OLIVIA",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-21",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1510299-TRNE",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901918",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901918-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "I.1901918",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORKER",
            "identifier": "I.1901918-SUPV",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.