Individual provider Active NPI

Jillian Christine Pacholke

  • Social Worker
  • Beachwood, OH
National Provider Identifier
1376410746
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.2512959 Issued in OH
Practice address
23366 Commerce Park Ste 100B
Beachwood, OH 44122-5801
Phone
(216) 292-2880
NPI assigned
Oct 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.2512959 OH Primary

Addresses

Primary practice location

23366 Commerce Park Ste 100B
Beachwood, OH 44122-5801

Mailing address

23366 Commerce Park Ste 100B
Beachwood, OH 44122-5801
Phone (216) 292-2880

Other identifiers 1

IdentifierTypeStateIssuer
0346639MedicaidOH

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.2512959OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psycho Social Therapies,LTD CurrentSince Nov 7, 2025 Accepting new patients
Psycho Social Therapies,LTD CurrentSince Nov 7, 2025 Accepting new patients

Locations

23366 Commerce Park
Ste 100B
Beachwood, OH 44122
Phone (216) 292-2880

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": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1376410746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23366 COMMERCE PARK STE 100B",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225801",
            "telephone_number": "216-292-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23366 COMMERCE PARK STE 100B",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225801",
            "telephone_number": "216-292-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHOLKE",
        "first_name": "JILLIAN",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2512959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0346639",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; 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.