Individual provider Active NPI

Lauren Catherine Hackley, LSW

  • Social Worker
  • Canton, OH
National Provider Identifier
1275337735
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.2410960 Issued in OH
Practice address
4510 Dressler Rd NW
Canton, OH 44718-2546
Phone
(216) 450-1613
NPI assigned
Apr 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.2410960 OH Primary

Addresses

Primary practice location

4510 Dressler Rd NW
Canton, OH 44718-2546

Mailing address

PO Box 844020
Dallas, TX 75284-4020
Phone (216) 450-1613

Other names 1

  • Ren Hackley Other name

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

LicenseStateTypeSpecialty
S.2410960OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Recovery Concepts LLC CurrentSince Apr 6, 2025 Accepting new patients
Axis Mental Health and Wellness PastSince Apr 6, 2025 Accepting new patients

Locations

4510 Dressler Rd NW
Canton, OH 44718
Phone (330) 494-5155

Organizations & group practices 2

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": "1743638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1275337735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844020",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844020",
            "telephone_number": "216-450-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182546",
            "telephone_number": "216-450-1613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKLEY",
        "first_name": "LAUREN",
        "middle_name": "CATHERINE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2410960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REN",
            "last_name": "HACKLEY",
            "credential": "LSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.