Individual provider Active NPI

Matt Tumblin, LSW

  • Clinical Social Worker
  • Cambridge, OH
National Provider Identifier
1376023507
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.1802451 Issued in OH
Practice address
1200 E Wheeling Ave
Cambridge, OH 43725-2510
Phone
(740) 432-1800
Fax
(740) 432-9299
NPI assigned
Aug 16, 2018
Last updated
Aug 16, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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 S.1802451 OH Primary

Addresses

Primary practice location

1200 E Wheeling Ave
Cambridge, OH 43725-2510

Mailing address

1200 E Wheeling Ave
Cambridge, OH 43725-2510
Phone (740) 432-1800

Other practice location 1

128 S 12th St
Cambridge, OH 43725-2449
Phone (740) 432-1800

Other identifiers 1

IdentifierTypeStateIssuer
S.1802451OtherOHCOUNSELOR SOCIAL WORKER & MFT BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.1802451OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
People to People, LLC. PastSince Aug 4, 2009 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1376023507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E WHEELING AVE",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437252510",
            "telephone_number": "740-432-1800",
            "fax_number": "740-432-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E WHEELING AVE",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437252510",
            "telephone_number": "740-432-1800",
            "fax_number": "740-432-9299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 S 12th St",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "OH",
            "postal_code": "437252449",
            "country_code": "US",
            "telephone_number": "740-432-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUMBLIN",
        "first_name": "MATT",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1802451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNSELOR SOCIAL WORKER & MFT BOARD",
            "identifier": "S.1802451",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.