Individual provider Active NPI

Mitzie A Barnes, LISW

  • Clinical Social Worker
  • Medina, OH
National Provider Identifier
1336312461
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I1947 Issued in OH
Practice address
3591 Reserve Commons Dr
Suite 301
Medina, OH 44256-5334
Phone
(330) 764-7916
Fax
(330) 723-6399
NPI assigned
Apr 9, 2008
Last updated
Apr 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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 I1947 OH Primary

Addresses

Primary practice location

3591 Reserve Commons Dr
Suite 301
Medina, OH 44256-5334

Mailing address

3591 Reserve Commons Dr
Suite 301
Medina, OH 44256-5334
Phone (330) 764-7916

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I1947OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Consultants Inc Clinical PastSince Nov 7, 1997 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/psychologyconsultantsinc/r4/

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, 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": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1336312461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3591 RESERVE COMMONS DR",
            "address_2": "SUITE 301",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565334",
            "telephone_number": "330-764-7916",
            "fax_number": "330-723-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3591 RESERVE COMMONS DR",
            "address_2": "SUITE 301",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565334",
            "telephone_number": "330-764-7916",
            "fax_number": "330-723-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "MITZIE",
        "middle_name": "A",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.