Anya L Mack, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I1500756SUPV Issued in OH

Practice address

1660 Nave Rd SE
Massillon, OH 44646-9604

Phone

(330) 837-9411

Fax

(330) 837-4603

NPI assigned

Feb 15, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anyamack@direct2.communityhealthlink.org

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.

• Community Healthlink Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Worcester, MA
  • NPI 1649293028
  NPD
• Community Healthlink, Inc.

  • Community Health Clinic/Center
  • Worcester, MA
  • NPI 1235387879
  NPD

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1376840017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021805",
            "telephone_number": "304-550-3743",
            "fax_number": "330-453-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 NAVE RD SE",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469604",
            "telephone_number": "330-837-9411",
            "fax_number": "330-837-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "ANYA",
        "middle_name": "L",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-15",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1500756SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0194566",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Lozano Tauchen, SLP
• Michelle Lynn Lucariello
• Caleb Lyman
• Heather Lynn, OT
• Judith M Lyons
• Macwheels LLC
• Maria Maglione, RN
• Kathleen Christin Malone, LPC
• Stacey Manos, CNP
• Greg Vaughan Manson, MD

• Clinical Social Worker in Massillon, OH
• Providers in Massillon, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.