Lauren Clark, LISW
Individual provider Active NPI Clinical Social Worker · Streetsboro, OH
NPI 1366830010 · NPPES record last updated Sep 26, 2024
Key facts
- NPI
- 1366830010
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I.1440086 (OH)
- Practice address
- 295 Ruby LN
Streetsboro, OH 44241-4126 - Phone
- (330) 962-2045
- NPI assigned
- Jan 5, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Hope Behavioral Health LLC
Practice addresses (Care Compare)
24100 Chagrin Blvd
Suite 330
Beachwood, OH 44122-5552
Phone (800) 642-4560
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170623000843 | OH | Practitioner - Clinical Social Worker | 2961770565 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I.1440086 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fortis Counseling and Consulting, LLC | Clinical | Current |
Accepting new patients |
| Fortis Counseling and Consulting, LLC | Clinical | Current |
Accepting new patients |
| Hope Behavioral Health LLC | Clinical | Current |
Accepting new patients |
| Beech Brook | Past | Accepting new patients |
Locations
24100 Chagrin Blvd
Ste 330
Beachwood, OH 44122
Phone (800) 642-4560
33595 Bainbridge Rd
Ste 101
Solon, OH 44139
Phone (216) 534-3822
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I.1440086 | OH | Yes |
Addresses
Primary practice location
295 Ruby LN
Streetsboro, OH 44241-4126
Mailing address
295 Ruby LN
Streetsboro, OH 44241-4126
Phone (330) 962-2045
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2871101 | Medicaid | OH |
Other providers in Streetsboro, OH
- Judy Christensen
- Kim Christensen
- Amy Marie Ciardi
- Steve J Cigany Jr.
- City of Streetsboro
- Close to Home Nursing Care and Rehab
- Stephane C Cross
- Wyatt Allen Crowell
- Bailee R D'Amore-Dicamillo
- Jeffrey Mark Danczak
All providers in Streetsboro, OH · Clinical Social Worker in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.