Individual provider Active NPI

Judith Dean, LISW-S

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1376631416
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I 0008305 Issued in OH
Practice address
765 Pierce Dr
Columbus, OH 43223-2425
Phone
(614) 223-1650
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2016

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 0008305 OH Primary

Addresses

Primary practice location

765 Pierce Dr
Columbus, OH 43223-2425

Mailing address

765 Pierce Dr
Columbus, OH 43223-2425
Phone (614) 223-1650

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
I20061219000299 OH Practitioner - Clinical Social Worker 7416956586 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I 0008305OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast, Inc CurrentSince Apr 4, 2017 Accepting new patients
Southeast, Inc CurrentSince Apr 4, 2017 Accepting new patients

Locations

1455 S 4th St
Columbus, OH 43207
Phone (614) 444-0800

16 W Long St
Columbus, OH 43215

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1376631416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 PIERCE DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432232425",
            "telephone_number": "614-223-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 PIERCE DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432232425",
            "telephone_number": "614-223-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "JUDITH",
        "name_prefix": "Ms.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 0008305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.