Individual provider Active NPI

Nicole Marie Noscal, LISW

  • Clinical Social Worker
  • Ashtabula, OH
National Provider Identifier
1174836258
Registry record updated Jul 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I 0900061 Issued in OH
Practice address
4200 Park Ave FL 2
Ashtabula, OH 44004-6887
Phone
(440) 992-8552
Fax
(440) 992-6631
NPI assigned
Jul 19, 2010
Last updated
Jul 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2010

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 I 0900061 OH Primary

Addresses

Primary practice location

4200 Park Ave FL 2
Ashtabula, OH 44004-6887

Mailing address

2723 Forman Rd
Rock Creek, OH 44084-9609
Phone (440) 563-9697

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
I20100819000881 OH Practitioner - Clinical Social Worker 8628102134 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I 0900061OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Health, Inc CurrentSince May 28, 2023 Accepting new patients
Signature Health, Inc. Current Accepting new patients
Signature Health Inc CurrentSince May 28, 2023 Accepting new patients
Signature Health, Inc Past Accepting new patients

Locations

4726 Main Ave
Ashtabula, OH 44004
Phone (440) 992-8552

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333

38882 Mentor Ave
Willoughby, OH 44094

Organizations & group practices 4

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": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1174836258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2723 FORMAN RD",
            "city": "ROCK CREEK",
            "state": "OH",
            "postal_code": "440849609",
            "telephone_number": "440-563-9697",
            "fax_number": "440-474-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 PARK AVE FL 2",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046887",
            "telephone_number": "440-992-8552",
            "fax_number": "440-992-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOSCAL",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 0900061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

Verify at the official NPI Registry.