Individual provider Active NPI

Rachel Tassile, LISW

  • Clinical Social Worker
  • Canton, OH
National Provider Identifier
1134617988
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2607864 Issued in OH
Practice address
4522 Fulton Dr NW
Canton, OH 44718-2332
Phone
(330) 915-2907
Fax
(330) 915-2958
NPI assigned
Apr 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.2607864 OH Primary
Social Worker 104100000X S.1600221 OH

Addresses

Primary practice location

4522 Fulton Dr NW
Canton, OH 44718-2332

Mailing address

4522 Fulton Dr NW
Canton, OH 44718-2332
Phone (330) 915-2907

Other practice location 1

4200 Munson St NW Ste A
Canton, OH 44718-2981
Phone (330) 915-2907

Other practice location 2

5611 Hudson Dr Ste 400
Hudson, OH 44236-4452
Phone (330) 915-2907

Other identifiers 1

IdentifierTypeStateIssuer
0282290MedicaidOH

Other names 1

  • Rachel Maureen Potoczek Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260316003454 OH Practitioner - Clinical Social Worker 9739662925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness Grove LLCGroup PAC ID 5092104109, 25 clinicians

Practice addresses (Care Compare)

4522 Fulton Dr NW
Canton, OH 44718-2332
Phone (330) 915-2907

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1600221OHMDSocial Worker
I.2607864OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Grove, LLC Social Worker CurrentSince Jun 25, 2023 Accepting new patients
Wellness Grove LLC Social Worker CurrentSince Mar 5, 2026 Accepting new patients

Locations

4200 Munson St NW
Ste A
Canton, OH 44718
Phone (330) 915-2907

4522 Fulton Dr NW
Canton, OH 44718
Phone (330) 915-2907

5611 Hudson Dr
Ste 400
Hudson, OH 44236
Phone (330) 915-2907

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1134617988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4522 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182332",
            "telephone_number": "330-915-2907",
            "fax_number": "330-915-2958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4522 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182332",
            "telephone_number": "330-915-2907",
            "fax_number": "330-915-2958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 Munson St NW Ste A",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447182981",
            "country_code": "US",
            "telephone_number": "330-915-2907",
            "fax_number": "330-915-2958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5611 Hudson Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "OH",
            "postal_code": "442364452",
            "country_code": "US",
            "telephone_number": "330-915-2907",
            "fax_number": "330-915-2958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TASSILE",
        "first_name": "RACHEL",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-27",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2607864",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1600221",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0282290",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "POTOCZEK",
            "middle_name": "MAUREEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.