Individual provider Active NPI

Manicka L Thomas, LSW

  • Clinical Social Worker
  • Dayton, OH
National Provider Identifier
1235500596
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
4699 Salem Ave
Dayton, OH 45416-1724
Phone
(937) 421-1268
NPI assigned
Oct 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1000837 OH
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

4699 Salem Ave
Dayton, OH 45416-1724

Mailing address

4699 Salem Ave
Dayton, OH 45416-1724
Phone (937) 421-1268

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
I20180207002346 OH Practitioner - Clinical Social Worker 7911267166 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1000837OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Access Behavioral LLC Social Worker CurrentSince Dec 5, 2017 Accepting new patients
Access Ohio, LLC CurrentSince Dec 5, 2017 Accepting new patients
Access Ohio, LLC CurrentSince Dec 5, 2017 Accepting new patients
Cartwheel Health Services PC Clinical Past Accepting new patients

Locations

8100 Ravines Edge Ct
Ste 200
Columbus, OH 43235
Phone (614) 655-3345

6400 E Broad St
Ste 400
Columbus, OH 43213
Phone (614) 367-7700

2611 Wayne Ave
Dayton, OH 45420
Phone (937) 228-0579

2611 Wayne Ave
Bldg 61
Dayton, OH 45420
Phone (937) 228-0579

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1235500596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4699 SALEM AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454161724",
            "telephone_number": "937-421-1268",
            "fax_number": "937-736-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4699 SALEM AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454161724",
            "telephone_number": "937-421-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MANICKA",
        "middle_name": "L",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1000837",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.