Individual provider Active NPI

Stephanie Farrell, LISW

  • Clinical Social Worker
  • Akron, OH
National Provider Identifier
1194339069
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S2004953 Issued in OH
Practice address
640 W Market St
Akron, OH 44303-1465
Phone
(330) 762-5425
NPI assigned
Sep 8, 2020
Last updated
Nov 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 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 S2004953 OH Primary

Addresses

Primary practice location

640 W Market St
Akron, OH 44303-1465

Mailing address

640 W Market St
Akron, OH 44303-1465

Other identifiers 2

IdentifierTypeStateIssuer
I2304675OtherOHLISW
S2004953OtherOHLICENSED SOCIAL WORKER

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
I20231030002378 OH Practitioner - Clinical Social Worker 6002262920 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S2004953OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Apr 17, 2024 Accepting new patients
Blick Clinic, Inc. CurrentSince Oct 23, 2023 Accepting new patients
Blick Clinic, Inc. CurrentSince Oct 23, 2023 Accepting new patients
Blick Clinic, Inc. Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

640 W Market St
Akron, OH 44303
Phone (330) 762-5425

274 White Pond Dr
Akron, OH 44320
Phone (330) 762-5425

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

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": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1194339069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 W MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443031465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 W MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443031465",
            "telephone_number": "330-762-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "STEPHANIE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S2004953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISW",
            "identifier": "I2304675",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED SOCIAL WORKER",
            "identifier": "S2004953",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.