Active NPI
Summer Poland, LSW
- Community/Behavioral Health Agency
- Defiance, OH
National Provider Identifier
1285248146
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jul 18, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- LSW
- Practice address
- 511 Perry St
Defiance, OH 43512-2123 - Phone
- (419) 782-9920
- Fax
- (419) 784-2523
- NPI assigned
- Sep 8, 2020
- 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 |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | LSW | OH | Primary |
Addresses
Primary practice location
511 Perry St
Defiance, OH 43512-2123
Mailing address
321 Kaufman St
Holgate, OH 43527-9566
Phone (419) 619-8802
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LSW | Other | OH | COUNSELOR, SOCIAL WORKER, & MFT BOARD |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSW | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1285248146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 KAUFMAN ST",
"city": "HOLGATE",
"state": "OH",
"postal_code": "435279566",
"telephone_number": "419-619-8802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 PERRY ST",
"city": "DEFIANCE",
"state": "OH",
"postal_code": "435122123",
"telephone_number": "419-782-9920",
"fax_number": "419-784-2523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLAND",
"first_name": "SUMMER",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-08",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "OH",
"license": "LSW",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COUNSELOR, SOCIAL WORKER, & MFT BOARD",
"identifier": "LSW",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Defiance, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.