Individual provider Active NPI

Jennifer Weaver, MSW, LISW-S

  • Clinical Social Worker
  • Mason, OH
National Provider Identifier
1346722907
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-1801192 Issued in OH
Practice address
8559 S Mason Montgomery Rd
Mason, OH 45040-9381
Phone
(513) 229-8980
NPI assigned
Aug 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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-1801192 OH Primary

Addresses

Primary practice location

8559 S Mason Montgomery Rd
Mason, OH 45040-9381

Mailing address

3733 Wrenwood CT
Mason, OH 45040-8770
Phone (513) 604-1965

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
I20240205002143 OH Practitioner - Clinical Social Worker 6901249101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Ohio IncGroup PAC ID 7719325083, 67 clinicians

Practice addresses (Care Compare)

8559 S Mason Montgomery Rd
Suite 25 26
Mason, OH 45040-9381
Phone (614) 459-4490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-1801192OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Ohio, Inc Current Accepting new patients
Optum Behavioral Care of Ohio, Inc CurrentSince Apr 1, 2024 Accepting new patients
Optum Behavioral Care of Ohio, Inc. Clinical CurrentSince Apr 1, 2024 Accepting new patients
The Counseling and Cooperative Parenting Center of Ohio, LLC Clinical Past Accepting new patients

Locations

4624 Sawmill Rd
Columbus, OH 43220
Phone (614) 457-4490

8559 S Mason Montgomery Rd
Ste 2526
Mason, OH 45040

3055 Kettering Blvd
Ste 218
Moraine, OH 45439
Phone (937) 813-1292

Interoperability endpoints

  • Direct secure messaging: jennifer.weaver.1@28621.direct.athenahealth.com

Organizations & group practices 4

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": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1346722907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3733 WRENWOOD CT",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408770",
            "telephone_number": "513-604-1965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8559 S MASON MONTGOMERY RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450409381",
            "telephone_number": "513-229-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "JENNIFER",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-1801192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.