NPIMap

Organization Active NPI

Enliven Resources, LLC

Doing business as Enliven Resource

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1376820209
Registry record updated Jan 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0700102-SUPV Issued in OH
Legal business name
ENLIVEN RESOURCES, LLC
Doing business as
Enliven Resource
Practice address
929 Harrison Ave
304
Columbus, OH 43215-1346
Phone
(614) 940-4868
Fax
(614) 923-7525
NPI assigned
Nov 6, 2011
Last updated
Jan 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2013

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

Authorized official

Name
Brock Allan Bauer, LISW-S, SAPNPI 1407090897
Title
Owner
Phone
(614) 940-4868

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X I.0700102-SUPV OH Primary

Addresses

Primary practice location

929 Harrison Ave
304
Columbus, OH 43215-1346

Mailing address

929 Harrison Ave
304
Columbus, OH 43215-1346
Phone (614) 940-4868

Other names 1

  • Enliven Resource Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130322000054 OH Part B Supplier - Clinic/Group Practice 9537304530 Receives reassigned benefits from 3 practitioners
Practice locations: Columbus, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1320537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356998400000",
    "number": "1376820209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 HARRISON AVE",
            "address_2": "304",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151346",
            "telephone_number": "614-940-4868",
            "fax_number": "614-923-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 HARRISON AVE",
            "address_2": "304",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151346",
            "telephone_number": "614-940-4868",
            "fax_number": "614-923-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENLIVEN RESOURCES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-06",
        "last_updated": "2013-01-01",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "BROCK",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-940-4868",
        "authorized_official_credential": "LISW-S, SAP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0700102-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enliven Resource",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.