Individual provider Active NPI

Michaela M.B. Little, LISW-S

  • Clinical Social Worker
  • Mason, OH
National Provider Identifier
1376959551
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1201090-SUPV Issued in OH
Practice address
8479 S Mason Montgomery Rd Ste 4
Mason, OH 45040-4023
Phone
(513) 445-8393
Fax
(513) 725-1141
NPI assigned
Jul 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6405-S NV
Clinical Social Worker 1041C0700X I.1201090-SUPV OH Primary

Addresses

Primary practice location

8479 S Mason Montgomery Rd Ste 4
Mason, OH 45040-4023

Mailing address

8479 S Mason Montgomery Rd Ste 4
Mason, OH 45040-4023
Phone (513) 445-8393

Other identifiers 1

IdentifierTypeStateIssuer
0172131MedicaidOH

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
I20160519000520 OH Practitioner - Clinical Social Worker 8022307792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Cincinnati College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lindner Center of Hope Professional AssociatesGroup PAC ID 7012236409, 72 clinicians

Practice addresses (Care Compare)

4075 Old Western Row Rd
Mason, OH 45040-3104
Phone (513) 536-4673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6405-SNVMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Craig and Frances Lindner Center of Hope CurrentSince Apr 1, 2024 Accepting new patients
Lindner Center of Hope Professional Associates Social Worker CurrentSince Apr 1, 2024 Accepting new patients
Modern Psychiatry & Wellness, LLC CurrentSince Nov 1, 2020 Accepting new patients

Locations

1910 Fairgrove Ave
Ste E
Hamilton, OH 45011
Phone (513) 299-4025

4075 Old Western Row Rd
Mason, OH 45040
Phone (513) 536-0232

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1376959551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8479 S MASON MONTGOMERY RD STE 4",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450404023",
            "telephone_number": "513-445-8393",
            "fax_number": "513-725-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8479 S MASON MONTGOMERY RD STE 4",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450404023",
            "telephone_number": "513-445-8393",
            "fax_number": "513-725-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "MICHAELA",
        "middle_name": "M.B.",
        "name_prefix": "Ms.",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NV",
            "license": "6405-S",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1201090-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0172131",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.