Individual provider Active NPI

Therese Grady-Dolan, LISW

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1396802765
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-0008513 Issued in OH
Practice address
3345 Glenmore Ave
Cincinnati, OH 45211-6543
Phone
(513) 481-7500
Fax
(513) 481-6316
NPI assigned
Jan 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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-0008513 OH Primary

Addresses

Primary practice location

3345 Glenmore Ave
Cincinnati, OH 45211-6543

Mailing address

3345 Glenmore Ave
Cincinnati, OH 45211-6543
Phone (513) 481-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-0008513OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396802765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3345 GLENMORE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452116543",
            "telephone_number": "513-481-7500",
            "fax_number": "513-481-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 GLENMORE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452116543",
            "telephone_number": "513-481-7500",
            "fax_number": "513-481-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADY-DOLAN",
        "first_name": "THERESE",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0008513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.