Destinie Shyanne Ford, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2405823 Issued in OH

Practice address

5123 Norwich St Ste 110
Hilliard, OH 43026-1486

Phone

(614) 980-4736

NPI assigned

Apr 18, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Psychological & Behavioral Consultants, LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713

  Clinical

  NPD (past)
• Shana Kemp-Price Counseling Associates Dba Modern Therapy

  • Mental Health Counselor
  • Powell, OH
  • NPI 1811541337
  NPD (past)

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1356084263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5123 NORWICH ST STE 110",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430261486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5123 NORWICH ST STE 110",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430261486",
            "telephone_number": "614-980-4736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "DESTINIE",
        "middle_name": "SHYANNE",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.2005268",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2405823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Fleshman, MD
• Victoria Paige Fliehman, PA-C
• Sheila Flores
• Nicole K. Fogel, LCSW
• Lexys Folsom
• Julie Ford, PT
• Foundation Health Pharmacy, LLC
• Jeffrey M. Fowler, M.D.
• Diane Fox
• Michele Marie Fox, LPN

• Clinical Social Worker in Hilliard, OH
• Providers in Hilliard, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.