Active NPI
Deryl Sterling Nazor, L.S.W.
- Clinical Social Worker
- Ashtabula, OH
National Provider Identifier
1215076047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S0003409
- Practice address
- 4200 Park Ave
3Rd Floor
Ashtabula, OH 44004-6887 - Phone
- (440) 992-2121
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S0003409 | OH | Primary |
Addresses
Primary practice location
4200 Park Ave
3Rd Floor
Ashtabula, OH 44004-6887
Mailing address
2306 Walnut Blvd.
P O Box 802
Ashtabula, OH 44005-0802
Phone (440) 964-9496
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S0003409 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Catholic Charities of Ashtabula County | Clinical | Past | Accepting new patients |
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.
-
- Adult Mental Health Clinic/Center
- Ashtabula, OH
- NPI 1851352959
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215076047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2306 WALNUT BLVD.",
"address_2": "P O BOX 802",
"city": "ASHTABULA",
"state": "OH",
"postal_code": "440050802",
"telephone_number": "440-964-9496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 PARK AVE",
"address_2": "3RD FLOOR",
"city": "ASHTABULA",
"state": "OH",
"postal_code": "440046887",
"telephone_number": "440-992-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAZOR",
"first_name": "DERYL",
"middle_name": "STERLING",
"name_prefix": "Mr.",
"credential": "L.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "S0003409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashtabula, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.