Individual provider Active NPI

Marissa Kaitlyn Ayers

  • Clinical Social Worker
  • Toledo, OH
National Provider Identifier
1205449394
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
3909 Woodley Rd
Toledo, OH 43606-1169
Phone
(419) 725-3330
NPI assigned
Aug 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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 Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

3909 Woodley Rd
Toledo, OH 43606-1169

Mailing address

3909 Woodley Rd
Toledo, OH 43606-1169
Phone (567) 455-5334

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
I20241105000853 OH Practitioner - Clinical Social Worker 3072047661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HarborGroup PAC ID 8325931181, 58 clinicians

Practice addresses (Care Compare)

3909 Woodley Rd
Toledo, OH 43606-1169
Phone (419) 475-4449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Clinical CurrentSince Sep 27, 2024 Accepting new patients

Locations

3909 Woodley Rd
Toledo, OH 43606
Phone (419) 725-3330

123 22nd St
Toledo, OH 43604
Phone (419) 241-6191

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, 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": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1205449394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 WOODLEY RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061169",
            "telephone_number": "567-455-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 WOODLEY RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436061169",
            "telephone_number": "419-725-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYERS",
        "first_name": "MARISSA",
        "middle_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.