Active NPI
Holly Aileen Disch Stoddard, MSSA, LISW
- Clinical Social Worker
- Berea, OH
National Provider Identifier
1306450150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.2405411
- Practice address
- 398 W Bagley Rd Ste 13
Berea, OH 44017-1312 - Phone
- (440) 970-3790
- Fax
- (440) 527-8043
- NPI assigned
- Aug 31, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I.2405411 | OH | Primary |
Addresses
Primary practice location
398 W Bagley Rd Ste 13
Berea, OH 44017-1312
Mailing address
398 W Bagley Rd Ste 13
Berea, OH 44017-1312
Phone (440) 970-3790
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0448980 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cheshire Wellness LLC | Addiction (Substance Use Disorder) | Current | Accepting new patients |
| Women'S Center of Greater Cleveland | Addiction (Substance Use Disorder) | Past | Accepting new patients |
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.
-
- Clinical Social Worker
- Cincinnati, OH
- NPI 1831933787
Addiction (Substance Use Disorder)
-
- Addiction (Substance Use Disorder) Counselor
- Cleveland, OH
- NPI 1063470888
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724198400000",
"number": "1306450150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "398 W BAGLEY RD STE 13",
"city": "BEREA",
"state": "OH",
"postal_code": "440171312",
"telephone_number": "440-970-3790",
"fax_number": "440-527-8043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "398 W BAGLEY RD STE 13",
"city": "BEREA",
"state": "OH",
"postal_code": "440171312",
"telephone_number": "440-970-3790",
"fax_number": "440-527-8043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STODDARD",
"first_name": "HOLLY",
"middle_name": "AILEEN DISCH",
"name_prefix": "Mrs.",
"credential": "MSSA, LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-31",
"last_updated": "2024-08-21",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.2405411",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0448980",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Berea, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.