Individual provider Active NPI

Victoriya Reich, LISW-S

  • Clinical Social Worker
  • Powell, OH
National Provider Identifier
1205116084
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1201142-SUPV Issued in OH
Practice address
185 S Liberty St
Powell, OH 43065-7619
Phone
(888) 875-8712
NPI assigned
Aug 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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.1201142-SUPV OH Primary

Addresses

Primary practice location

185 S Liberty St
Powell, OH 43065-7619

Mailing address

7736 Birchmont Dr
Chagrin Falls, OH 44022-3970
Phone (440) 666-1280

Other identifiers 1

IdentifierTypeStateIssuer
0156033MedicaidOH

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
I.1201142-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Theravault, LLC CurrentSince Mar 12, 2024 Accepting new patients

Locations

185 S Liberty St
Powell, OH 43065
Phone (614) 636-1439

Interoperability endpoints

  • Direct secure messaging: pbc.victoriyareich@140094.advancedmd-direct.com

Organizations & group practices 1

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": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1205116084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7736 BIRCHMONT DR",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440223970",
            "telephone_number": "440-666-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 S LIBERTY ST",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430657619",
            "telephone_number": "888-875-8712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICH",
        "first_name": "VICTORIYA",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1201142-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0156033",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.