Individual provider Active NPI

Christina R Hancock, LISW-S

  • Clinical Social Worker
  • Bryan, OH
National Provider Identifier
1366693236
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0800265-SUPV Issued in OH
Practice address
221 S Main St
Bryan, OH 43506-1759
Phone
(419) 636-8400
Fax
(419) 636-7953
NPI assigned
Oct 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 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.0800265-SUPV OH Primary

Addresses

Primary practice location

221 S Main St
Bryan, OH 43506-1759

Mailing address

21568 County Road C
Stryker, OH 43557-9709
Phone (419) 682-9163

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
I20091203000029 OH Practitioner - Clinical Social Worker 2961541057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3150 N Republic Blvd
Suite 5
Toledo, OH 43615-1514
Phone (419) 636-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hancock Counseling Clinical CurrentSince Jan 1, 2010 Accepting new patients
Ultra-X Imaging LLC PastSince Jan 1, 2010 Accepting new patients

Locations

221 S Main St
Bryan, OH 43506
Phone (419) 630-0211

1210 W High St
Fl 2
Bryan, OH 43506
Phone (419) 636-8400

3150 N Republic Blvd
Ste 5
Toledo, OH 43615
Phone (419) 636-8400

Organizations & group practices 2

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": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1366693236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21568 COUNTY ROAD C",
            "city": "STRYKER",
            "state": "OH",
            "postal_code": "435579709",
            "telephone_number": "419-682-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 S MAIN ST",
            "city": "BRYAN",
            "state": "OH",
            "postal_code": "435061759",
            "telephone_number": "419-636-8400",
            "fax_number": "419-636-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "CHRISTINA",
        "middle_name": "R",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-09",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0800265-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, OH

Sources for this page

Verify at the official NPI Registry.