Individual provider Active NPI

Erika Taddie-Osborn, LISW-S

  • Clinical Social Worker
  • Beachwood, OH
National Provider Identifier
1285023812
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0900059-SUPV Issued in OH
Practice address
25101 Chagrin Blvd
#100
Beachwood, OH 44122-5643
Phone
(216) 831-6611
Fax
(216) 456-8128
NPI assigned
Jan 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.0900059-SUPV OH Primary

Addresses

Primary practice location

25101 Chagrin Blvd
#100
Beachwood, OH 44122-5643

Mailing address

25101 Chagrin Blvd
#100
Beachwood, OH 44122-5643
Phone (216) 831-6611

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
I20150217000321 OH Practitioner - Clinical Social Worker 3072838903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

23625 Commerce Park
Suite 100
Beachwood, OH 44122-5845
Phone (216) 831-6611

25101 Chagrin Blvd
Suite 100
Beachwood, OH 44122-5643

25101 Chagrin Blvd
Suite 100
Beachwood, OH 44122-5694
Phone (216) 831-6611

25101 Chagrin Blvd
Suite 200
Beachwood, OH 44122-5656
Phone (216) 468-5000

25111 Country Club Blvd
Suite 290
North Olmsted, OH 44070-5330
Phone (440) 614-2520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0900059-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC Clinical CurrentSince Jan 20, 2015 Accepting new patients

Locations

23625 Commerce Park
Ste 100
Beachwood, OH 44122
Phone (844) 439-7976

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

25111 Country Club Blvd
Ste 290
North Olmsted, OH 44070
Phone (440) 614-2520

Interoperability endpoints

  • Direct secure messaging: pbc.erikataddieosborn@140094.advancedmd-direct.com

Organizations & group practices 1

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": "1421712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1285023812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25101 CHAGRIN BLVD",
            "address_2": "#100",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225643",
            "telephone_number": "216-831-6611",
            "fax_number": "216-456-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25101 CHAGRIN BLVD",
            "address_2": "#100",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225643",
            "telephone_number": "216-831-6611",
            "fax_number": "216-456-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADDIE-OSBORN",
        "first_name": "ERIKA",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-20",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0900059-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.