Individual provider Active NPI

Molly Crocker, LISW

  • Clinical Social Worker
  • Dublin, OH
National Provider Identifier
1316519119
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2103064 Issued in OH
Practice address
495 Metro PL S Ste 160
Dublin, OH 43017-5394
Phone
(614) 580-6917
NPI assigned
Jul 13, 2021
Last updated
Oct 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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.2103064 OH Primary

Addresses

Primary practice location

495 Metro PL S Ste 160
Dublin, OH 43017-5394

Mailing address

495 Metro PL S Ste 160
Dublin, OH 43017-5394
Phone (614) 580-6917

Other identifiers 1

IdentifierTypeStateIssuer
0452198MedicaidOH

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
I20210726003043 OH Practitioner - Clinical Social Worker 2860895075 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oh Independent Medical Group LLCGroup PAC ID 0648646034, 136 clinicians
Concord Psychiatry, LLCGroup PAC ID 3577884105, 37 clinicians

Practice addresses (Care Compare)

4995 Bradenton Ave
Suite 130
Dublin, OH 43017-3551
Phone (614) 580-6917

50 Old Village Rd
Suite 109
Columbus, OH 43228-1538
Phone (614) 580-6917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Psychiatry, LLC PastSince Jul 25, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1316519119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 METRO PL S STE 160",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175394",
            "telephone_number": "614-580-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 METRO PL S STE 160",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175394",
            "telephone_number": "614-580-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKER",
        "first_name": "MOLLY",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2103064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0452198",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.