Individual provider Active NPI

Marolyn Whaley-Buckel, LISW

  • Clinical Social Worker
  • Springfield, OH
National Provider Identifier
1134200090
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0003026 Issued in OH
Practice address
1130 Vester Ave
Suite C
Springfield, OH 45503-7302
Phone
(937) 390-3800
Fax
(937) 390-3804
NPI assigned
Oct 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 I0003026 OH Primary

Addresses

Primary practice location

1130 Vester Ave
Suite C
Springfield, OH 45503-7302

Mailing address

1130 Vester Ave
Suite C
Springfield, OH 45503-7302
Phone (937) 390-3800

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
I0003026OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Perspectives, Inc. Clinical PastSince Jul 15, 2002 Accepting new patients
Aspen Counseling Associates Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134200090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 VESTER AVE",
            "address_2": "SUITE C",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455037302",
            "telephone_number": "937-390-3800",
            "fax_number": "937-390-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 VESTER AVE",
            "address_2": "SUITE C",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455037302",
            "telephone_number": "937-390-3800",
            "fax_number": "937-390-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEY-BUCKEL",
        "first_name": "MAROLYN",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0003026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.