Active NPI
Nettie Ruth Mistic, LISW
- Social Worker
- Lancaster, OH
National Provider Identifier
1306819131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- I.0001796
- Practice address
- 131 N Ewing St
Unit B
Lancaster, OH 43130-3383 - Phone
- (740) 689-6700
- Fax
- (740) 689-6702
- NPI assigned
- Feb 10, 2006
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | I.0001796 | OH | Primary |
Addresses
Primary practice location
131 N Ewing St
Unit B
Lancaster, OH 43130-3383
Mailing address
131 N Ewing St
Unit B
Lancaster, OH 43130-3383
Phone (740) 689-6700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| I 0001796 | Other | OH | LICENSE NUMBER |
| 000000387062 | Other | OH | ANTHEM BCBS |
Other names 1
- Nettie Ruth Sturgeon
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1979
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
230 S Court St
Suite 5
Medina, OH 44256-2259
Phone (330) 723-7977
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avenues of Counseling and Mediation | Current | Accepting new patients | |
| River Valley Counseling, LLC | Past | Accepting new patients | |
| Lisa Borchert Dba Avenues of Counseling | Past | Accepting new patients |
Locations
230 S Court St
Ste 5
Medina, OH 44256
Phone (330) 723-7977
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.
-
- Mental Health Counselor
- Medina, OH
- NPI 1225253107
-
- Mental Health Counselor
- Medina, OH
- NPI 1750581179
-
- Mental Health Counselor
- Lancaster, OH
- NPI 1548214752
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306819131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 N EWING ST",
"address_2": "UNIT B",
"city": "LANCASTER",
"state": "OH",
"postal_code": "431303383",
"telephone_number": "740-689-6700",
"fax_number": "740-689-6702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 N EWING ST",
"address_2": "UNIT B",
"city": "LANCASTER",
"state": "OH",
"postal_code": "431303383",
"telephone_number": "740-689-6700",
"fax_number": "740-689-6702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISTIC",
"first_name": "NETTIE",
"middle_name": "RUTH",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "I.0001796",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "I 0001796",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000387062",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "NETTIE",
"last_name": "STURGEON",
"middle_name": "RUTH",
"credential": "LISW",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Lancaster, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.