Individual provider Active NPI

David Guardiola, MSW, LISW

  • Clinical Social Worker
  • Fremont, OH
National Provider Identifier
1376829986
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I1101260 Issued in OH
Practice address
1235 Carbon St
Fremont, OH 43420-1727
Phone
(567) 334-1989
NPI assigned
Oct 26, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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 I1101260 OH Primary

Addresses

Primary practice location

1235 Carbon St
Fremont, OH 43420-1727

Mailing address

1235 Carbon St
Fremont, OH 43420-1727

Other identifiers 2

IdentifierTypeStateIssuer
1376829986OtherNPI
12315045OtherCAQH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I1101260OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Concepts of Ohio CurrentSince Jan 26, 2022 Accepting new patients

Locations

602 W State St
Fremont, OH 43420
Phone (567) 334-1989

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1376829986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 CARBON ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434201727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 CARBON ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434201727",
            "telephone_number": "567-334-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUARDIOLA",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MSW, LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-26",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1101260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1376829986",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12315045",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.