Individual provider Active NPI

Becky J Wirsch, LISW-S

  • Clinical Social Worker
  • Hamilton, OH
National Provider Identifier
1386898633
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2002174-SUPV Issued in OH
Practice address
1490 University Blvd
Hamilton, OH 45011-3305
Phone
(513) 881-7189
Fax
(513) 881-7188
NPI assigned
Nov 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.2002174-SUPV OH Primary
Social Worker 104100000X S0700294 OH

Addresses

Primary practice location

1490 University Blvd
Hamilton, OH 45011-3305

Mailing address

1131 Manchester Ave
Middletown, OH 45042-1925
Phone (513) 422-7016

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
I20240530002211 OH Practitioner - Clinical Social Worker 8022450485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindfully LLCGroup PAC ID 3476606252, 66 clinicians

Practice addresses (Care Compare)

1251 Nilles Rd
Suite 5
Fairfield, OH 45014-7205
Phone (888) 830-0347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S0700294OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindfully, LLC Social Worker CurrentSince May 10, 2024 Accepting new patients
Mindfully, LLC Social Worker CurrentSince May 10, 2024 Accepting new patients
Mindfully Psychiatry LLC Past Accepting new patients

Locations

199 S Chillicothe Rd
Ste 207
Aurora, OH 44202

5630 Bridgetown Rd
Ste 4
Cincinnati, OH 45248
Phone (513) 252-8054

8040 Hosbrook Rd
Ste 320
Cincinnati, OH 45236
Phone (513) 861-9797

463 Ohio Pike
Ste 102B
Cincinnati, OH 45255
Phone (888) 262-3616

100 E Campus View Blvd
Ste 250
Columbus, OH 43235
Phone (267) 817-8902

10861 Yankee St
Dayton, OH 45458
Phone (937) 619-0800

5050 Blazer Pkwy
Ste 101
Dublin, OH 43017
Phone (614) 451-7346

1251 Nilles Rd
Ste 5
Fairfield, OH 45014
Phone (732) 993-4599

6100 Oak Tree Blvd
Ste 200
Independence, OH 44131
Phone (330) 344-9030

1715 Indian Wood Cir
Ste 200
Maumee, OH 43537
Phone (216) 770-9367

10547 Montgomery Rd
Ste 700
Montgomery, OH 45242
Phone (513) 393-0300

110 S College Ave
Fl 2
Oxford, OH 45056
Phone (513) 273-0020

11565 Pearl Rd
Ste 200
Strongsville, OH 44136
Phone (440) 846-0862

3000 Regency Ct
Ste 207
Toledo, OH 43623
Phone (419) 471-0493

5900 W Chester Rd
Ste C
West Chester, OH 45069
Phone (513) 777-2428

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": "1226534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1386898633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 MANCHESTER AVE",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450421925",
            "telephone_number": "513-422-7016",
            "fax_number": "513-422-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 UNIVERSITY BLVD",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450113305",
            "telephone_number": "513-881-7189",
            "fax_number": "513-881-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRSCH",
        "first_name": "BECKY",
        "middle_name": "J",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-13",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2002174-SUPV",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S0700294",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

Verify at the official NPI Registry.