Victoria Fowler Endicott, MSW, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I0008766 Issued in OH

Practice address

1125 Ellen Kay Dr
Ste D
Marion, OH 43302-6286

Phone

(740) 381-3874

Fax

(740) 382-2930

NPI assigned

Apr 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center Street Community Clinic IncGroup PAC ID 7012815210, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: victoria.endicott.p1@direct.centerstreetclinic.nextgenshare.com

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.

• Center Street Community Clinic Inc

  dba Center Street Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Marion, OH
  • NPI 1780984211
  Medicare reassignment Care Compare group NPD
• Center Street Community Clinic, Inc

  • Multi-Specialty Clinic/Center
  • Marion, OH
  • NPI 1609657766

  Clinical

  NPD

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1255393625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 ELLEN KAY DRIVE",
            "address_2": "SUITE D",
            "city": "MARION",
            "state": "OH",
            "postal_code": "43302",
            "telephone_number": "740-382-3874",
            "fax_number": "740-382-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 ELLEN KAY DR",
            "address_2": "STE D",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026286",
            "telephone_number": "740-381-3874",
            "fax_number": "740-382-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDICOTT",
        "first_name": "VICTORIA",
        "middle_name": "FOWLER",
        "credential": "MSW, LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I0008766",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0008766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rylee Eldridge
• Elgin Local School District
• Nourhan Elmonoufy, MD
• Embassy Marion, LLC
• Justine Emig
• Paige E Endsley
• Jan Engel, LISW-S
• John R Engle, MD
• Abbie Suzanne Engler, PA-C
• Eric P Buck, DDS, Marion, LLC (Cross Creek Dental Care of Marion)

• Clinical Social Worker in Marion, OH
• Providers in Marion, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.