Individual provider Active NPI

Despina Costandinidis, LISW

  • Clinical Social Worker
  • Beavercreek, OH
National Provider Identifier
1386123792
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1801128 Issued in OH
Practice address
3991 Largo LN
Beavercreek, OH 45430-1103
Phone
(937) 572-7028
NPI assigned
Aug 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 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 I.1801128 OH Primary

Addresses

Primary practice location

3991 Largo LN
Beavercreek, OH 45430-1103

Mailing address

3991 Largo LN
Beavercreek, OH 45430-1103
Phone (937) 572-7028

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
I20200418000041 OH Practitioner - Clinical Social Worker 0143650937 Practice locations: Kettering, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3085 Woodman Dr
Suite 380
Kettering, OH 45420-1159
Phone (937) 572-7028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1801128OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Amani Counseling, LLC Clinical CurrentSince Mar 1, 2020 Accepting new patients

Locations

3541 Dayton Xenia Rd
Unit 340358
Dayton, OH 45434

3876 Indian Ripple Rd
Ste A
Dayton, OH 45440
Phone (937) 230-1058

3085 Woodman Dr
Ste 380
Kettering, OH 45420
Phone (937) 230-1058

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": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1386123792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3991 LARGO LN",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454301103",
            "telephone_number": "937-572-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3991 LARGO LN",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454301103",
            "telephone_number": "937-572-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANDINIDIS",
        "first_name": "DESPINA",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1801128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.