Individual provider Active NPI

Cynthia Marie Adam, L.I.S.W.-S

  • Clinical Social Worker
  • Wooster, OH
National Provider Identifier
1386967172
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1500485 Issued in OH
Practice address
2000 Noble Dr
Wooster, OH 44691-5353
Phone
(330) 264-3232
NPI assigned
Mar 8, 2010
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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 S0901385 OH
Clinical Social Worker 1041C0700X I.1500485 OH Primary

Addresses

Primary practice location

2000 Noble Dr
Wooster, OH 44691-5353

Mailing address

2000 Noble Dr
Wooster, OH 44691-5353
Phone (330) 264-3232

Other practice location 1

1776 E Broad St
Columbus, OH 43203-1787
Phone (614) 253-8050

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
I20240807004513 OH Practitioner - Clinical Social Worker 7012454069 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S0901385OHMDSocial Worker
I.1500485OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Village Network CurrentSince Apr 28, 2024 Accepting new patients
Village Network CurrentSince Apr 28, 2024 Accepting new patients

Locations

1751 E Long St
Columbus, OH 43203
Phone (614) 253-8050

1776 E Broad St
Columbus, OH 43203
Phone (614) 253-8050

2000 Noble Dr
Wooster, OH 44691
Phone (330) 439-8492

3011 Akron Rd
Wooster, OH 44691
Phone (330) 202-3809

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1386967172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NOBLE DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915353",
            "telephone_number": "330-264-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NOBLE DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915353",
            "telephone_number": "330-264-3232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1776 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432031787",
            "country_code": "US",
            "telephone_number": "614-253-8050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAM",
        "first_name": "CYNTHIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "L.I.S.W.-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-08",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S0901385",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1500485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.