Individual provider Active NPI

Paul L Dovyak, LISW

  • Clinical Social Worker
  • Gallipolis, OH
National Provider Identifier
1225097678
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0003176 Issued in OH
Practice address
3086 State Route 160
Gallipolis, OH 45631-8409
Phone
(740) 446-5500
Fax
(740) 441-4402
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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 I0003176 OH Primary

Addresses

Primary practice location

3086 State Route 160
Gallipolis, OH 45631-8409

Mailing address

PO Box 188
Chillicothe, OH 45601-0188
Phone (740) 773-4366

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
I20120313000615 OH Practitioner - Clinical Social Worker 3971762873 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0003176OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hopewell Health Centers, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Hopewell Health Centers, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Hopewell Health Centers Inc Current Accepting new patients

Locations

90 Hospital Dr
Athens, OH 45701
Phone (740) 592-3091

3086 State Route 160
Gallipolis, OH 45631
Phone (740) 446-5500

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1225097678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456010188",
            "telephone_number": "740-773-4366",
            "fax_number": "740-773-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3086 STATE ROUTE 160",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456318409",
            "telephone_number": "740-446-5500",
            "fax_number": "740-441-4402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVYAK",
        "first_name": "PAUL",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0003176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallipolis, OH

Sources for this page

Verify at the official NPI Registry.