Individual provider Active NPI

Nellimaria Lavalle, LISW

  • Clinical Social Worker
  • Westerville, OH
National Provider Identifier
1194327007
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2304263 Issued in OH
Practice address
5011 Pine Creek Dr
Westerville, OH 43081-4849
Phone
(614) 948-3273
Fax
(855) 740-2025
NPI assigned
Nov 16, 2020
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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.2304263 OH Primary

Addresses

Primary practice location

5011 Pine Creek Dr
Westerville, OH 43081-4849

Mailing address

623 Park Meadow Rd Ste H
Westerville, OH 43081-2876
Phone (614) 948-3273

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
I20230308000584 OH Practitioner - Clinical Social Worker 4284007584 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oh Independent Medical Group LLC CurrentSince Oct 28, 2025 Accepting new patients
Oh Independent Medical Group LLC CurrentSince Oct 28, 2025 Accepting new patients
Serenity Behavioral Health Services, Inc. CurrentSince Feb 16, 2023 Accepting new patients

Locations

495 E Mound St
Ste 110
Columbus, OH 43215
Phone (614) 948-3273

929 Harrison Ave
Ste 200
Columbus, OH 43215
Phone (614) 940-4868

444 N Cleveland Ave
Ste 120
Westerville, OH 43082
Phone (614) 818-0300

5011 Pine Creek Dr
Westerville, OH 43081
Phone (614) 948-3273

623 Park Meadow Rd
Ste H
Westerville, OH 43081
Phone (614) 774-1120

Interoperability endpoints

  • Direct secure messaging: nellimaria.lavalle.1@26020.direct.athenahealth.com

Organizations & group practices 3

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": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1194327007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 PARK MEADOW RD STE H",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430812876",
            "telephone_number": "614-948-3273",
            "fax_number": "855-740-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011 PINE CREEK DR",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430814849",
            "telephone_number": "614-948-3273",
            "fax_number": "855-740-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVALLE",
        "first_name": "NELLIMARIA",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2304263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.