Individual provider Active NPI

Kaylin Schaefer, MSW, LISW-S

  • Clinical Social Worker
  • Berea, OH
National Provider Identifier
1346513769
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1101080 Issued in OH
Practice address
202 E Bagley Rd
Berea, OH 44017
Phone
(440) 234-2006
Fax
(440) 234-0787
NPI assigned
Feb 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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.1101080 OH Primary

Addresses

Primary practice location

202 E Bagley Rd
Berea, OH 44017

Mailing address

202 E Bagley Rd
Berea, OH 44017-2058
Phone (440) 234-2006

Other names 1

  • Kaylin Manley Former name

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
I.1101080OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1346513769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E BAGLEY RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440172058",
            "telephone_number": "440-234-2006",
            "fax_number": "440-234-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E BAGLEY RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "44017",
            "telephone_number": "440-234-2006",
            "fax_number": "440-234-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "KAYLIN",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-15",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1101080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLIN",
            "last_name": "MANLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 May 23, 2018; 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.