Individual provider Active NPI

Brittany Marie Edelbrock, MSW, LSW

  • Clinical Social Worker
  • Independence, OH
National Provider Identifier
1407322290
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2203859 Issued in OH
Practice address
6200 Rockside Woods Blvd N Ste 305
Independence, OH 44131-2343
Phone
(419) 438-7606
NPI assigned
Oct 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2023

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.2203859 OH Primary

Addresses

Primary practice location

6200 Rockside Woods Blvd N Ste 305
Independence, OH 44131-2343

Mailing address

214 Northridge Oval BLDG 2
Brooklyn, OH 44144-3218
Phone (419) 438-7606

Other names 1

  • Brittany Marie Lukaszek Former name

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
I20240207000427 OH Practitioner - Clinical Social Worker 3375986383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

20 S 3Rd St
Suite 210
Columbus, OH 43215-4206
Phone (866) 630-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.2203859OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Jan 24, 2024 Accepting new patients
Ohioguidestone Past Accepting new patients

Locations

20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1407322290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 NORTHRIDGE OVAL BLDG 2",
            "city": "BROOKLYN",
            "state": "OH",
            "postal_code": "441443218",
            "telephone_number": "419-438-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 ROCKSIDE WOODS BLVD N STE 305",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312343",
            "telephone_number": "419-438-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELBROCK",
        "first_name": "BRITTANY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2203859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "LUKASZEK",
            "middle_name": "MARIE",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Independence, OH

Sources for this page

Verify at the official NPI Registry.