Active NPI
Jerita Tarelle Williams, LSW
- Social Worker
- Groveport, OH
National Provider Identifier
1235625419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.0900544
- Practice address
- 3964 Hamilton Square Blvd
Groveport, OH 43125-9119 - Phone
- (234) 542-9457
- NPI assigned
- Jul 10, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | S.0900544 | OH | Primary |
Addresses
Primary practice location
3964 Hamilton Square Blvd
Groveport, OH 43125-9119
Mailing address
3942 Cleggan St
Canal Winchester, OH 43110-8125
Phone (234) 542-9457
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 |
|---|---|---|---|
| S.0900544 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531180800000",
"number": "1235625419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3942 CLEGGAN ST",
"city": "CANAL WINCHESTER",
"state": "OH",
"postal_code": "431108125",
"telephone_number": "234-542-9457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3964 HAMILTON SQUARE BLVD",
"city": "GROVEPORT",
"state": "OH",
"postal_code": "431259119",
"telephone_number": "234-542-9457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JERITA",
"middle_name": "TARELLE",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-10",
"last_updated": "2018-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker",
"state": "OH",
"license": "S.0900544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Groveport, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.