Individual provider Active NPI

Charles Shaffer, MSW

  • Mental Health Counselor
  • Cincinnati, OH
National Provider Identifier
1275048613
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
S.2005738 Issued in OH
Practice address
311 Albert Sabin Way
Cincinnati, OH 45229-2838
Phone
(513) 558-5823
NPI assigned
Dec 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X S.2005738 OH Primary

Addresses

Primary practice location

311 Albert Sabin Way
Cincinnati, OH 45229-2838

Mailing address

PO Box 55
Walton, KY 41094-0055

Other practice location 1

3012 Glenmore Ave
Cincinnati, OH 45238-2269
Phone (513) 849-8670

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
I20250307001543 OH Practitioner - Clinical Social Worker 0042731929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

311 Albert Sabin Way
Cincinnati, OH 45229-2838
Phone (513) 558-9006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.2005738OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Central Clinic Outpatient Services Mental Health CurrentSince Jan 1, 2025 Accepting new patients
Central Clinic Outpatient Services Mental Health CurrentSince Jan 1, 2025 Accepting new patients
Central Clinic Inc Mental Health Access Point Mental Health Current Accepting new patients

Locations

311 Albert Sabin Way
Cincinnati, OH 45229
Phone (513) 558-5823

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": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1275048613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55",
            "city": "WALTON",
            "state": "KY",
            "postal_code": "410940055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 ALBERT SABIN WAY",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452292838",
            "telephone_number": "513-558-5823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3012 Glenmore Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452382269",
            "country_code": "US",
            "telephone_number": "513-849-8670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-07",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "S.2005738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.