Individual provider Active NPI

Cindy R Kaufman, LISW-SUPV

  • Clinical Social Worker
  • Pepper Pike, OH
National Provider Identifier
1356646145
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0004593-SUPV Issued in OH
Practice address
3737 Lander Rd
Pepper Pike, OH 44124-5712
Phone
(216) 831-2255
Fax
(216) 378-3906
NPI assigned
Jan 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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.0004593-SUPV OH Primary

Addresses

Primary practice location

3737 Lander Rd
Pepper Pike, OH 44124-5712

Mailing address

3737 Lander Rd
Pepper Pike, OH 44124-5712
Phone (216) 831-2255

Other identifiers 1

IdentifierTypeStateIssuer
0268768MedicaidOH

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
I20141203001748 OH Practitioner - Clinical Social Worker 4587986450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindfully LLCGroup PAC ID 3476606252, 66 clinicians

Practice addresses (Care Compare)

463 Ohio Pike
Suite 102 B
Cincinnati, OH 45255-3721
Phone (888) 830-0347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mindfully, LLC Clinical CurrentSince Jun 1, 2024 Accepting new patients
Mindfully, LLC CurrentSince Jun 1, 2024 Accepting new patients
Mindfully Psychiatry LLC Past Accepting new patients

Locations

199 S Chillicothe Rd
Ste 207
Aurora, OH 44202

5630 Bridgetown Rd
Ste 4
Cincinnati, OH 45248
Phone (513) 252-8054

463 Ohio Pike
Ste 102B
Cincinnati, OH 45255
Phone (888) 262-3616

8040 Hosbrook Rd
Ste 320
Cincinnati, OH 45236
Phone (513) 861-9797

100 E Campus View Blvd
Ste 250
Columbus, OH 43235
Phone (267) 817-8902

10861 Yankee St
Dayton, OH 45458
Phone (937) 619-0800

5050 Blazer Pkwy
Ste 101
Dublin, OH 43017
Phone (614) 451-7346

1251 Nilles Rd
Ste 5
Fairfield, OH 45014
Phone (732) 993-4599

6100 Oak Tree Blvd
Ste 200
Independence, OH 44131
Phone (330) 344-9030

1715 Indian Wood Cir
Ste 200
Maumee, OH 43537
Phone (216) 770-9367

10547 Montgomery Rd
Ste 700
Montgomery, OH 45242
Phone (513) 393-0300

110 S College Ave
Fl 2
Oxford, OH 45056
Phone (513) 273-0020

11565 Pearl Rd
Ste 200
Strongsville, OH 44136
Phone (440) 846-0862

3000 Regency Ct
Ste 207
Toledo, OH 43623
Phone (419) 471-0493

5900 W Chester Rd
Ste C
West Chester, OH 45069
Phone (513) 777-2428

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1356646145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 LANDER RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245712",
            "telephone_number": "216-831-2255",
            "fax_number": "216-378-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 LANDER RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245712",
            "telephone_number": "216-831-2255",
            "fax_number": "216-378-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "CINDY",
        "middle_name": "R",
        "credential": "LISW-SUPV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0004593-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0268768",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pepper Pike, OH

Sources for this page

Verify at the official NPI Registry.