Michelle Fridman, LISW, LICDC
Individual provider Active NPI Clinical Social Worker · Delaware, OH
NPI 1376900191 · NPPES record last updated Jan 25, 2016
Key facts
- NPI
- 1376900191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I. 1501006 (OH)
- Practice address
- 824 Bowtown Rd
Delaware, OH 43015-9661 - Phone
- (740) 369-7688
- Fax
- (740) 363-6415
- NPI assigned
- Jan 25, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160324000735 | OH | Practitioner - Clinical Social Worker | 0749587483 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ICDC 091064 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| I. 1501006 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Ohio, LLC | Current |
Accepting new patients | |
| Access Ohio, LLC | Current |
Accepting new patients | |
| Ohioguidestone | Current | Accepting new patients | |
| Ohioguidestone | Current |
Accepting new patients | |
| Ohioguidestone | Current |
Accepting new patients |
Locations
202 E Bagley Rd
Berea, OH 44017
Phone (440) 260-8327
8100 Ravines Edge Ct
Ste 200
Columbus, OH 43235
Phone (614) 655-3345
6400 E Broad St
Ste 400
Columbus, OH 43213
Phone (614) 367-7700
195 N Grant Ave
Ste 250
Columbus, OH 43215
Phone (440) 260-6408
2611 Wayne Ave
Dayton, OH 45420
Phone (937) 228-0579
2611 Wayne Ave
Bldg 61
Dayton, OH 45420
Phone (937) 228-0579
250 S Henry St
Delaware, OH 43015
Phone (740) 369-4482
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | ICDC 091064 | OH | |
| Clinical Social Worker | 1041C0700X | I. 1501006 | OH | Yes |
Addresses
Primary practice location
824 Bowtown Rd
Delaware, OH 43015-9661
Mailing address
250 S Henry St
Delaware, OH 43015-2978
Phone (740) 369-4908
Other names
- Michelle Webb
Other providers in Delaware, OH
- Erica McCuen Foster
- Kathrine Fox
- Jennifer Nicole Franklin Kearns
- Gerald Thomas French
- Dmitriy Fridman
- Matthew Daniel Fuerst
- Raymond D. Fuller
- G.M. Health Services, Inc.
- Amy Lynn Gabel
- Jarrod Gable
All providers in Delaware, OH · Clinical Social Worker in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.