Individual provider Active NPI

Meshalle Johnston, LISW-S

  • Clinical Social Worker
  • Beavercreek, OH
National Provider Identifier
1407466287
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0010097-SUPV Issued in OH
Practice address
2900 Presidential Dr Ste 100
Beavercreek, OH 45324-6502
Phone
(216) 468-5000
NPI assigned
Aug 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X 21824458 OH
Personal Care Attendant 3747P1801X OH
Home Health Aide 374U00000X OH
Clinical Social Worker 1041C0700X I.0010097-SUPV OH Primary

Addresses

Primary practice location

2900 Presidential Dr Ste 100
Beavercreek, OH 45324-6502

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630
Phone (216) 468-5000

Other practice location 1

13006 Maplerow Ave
Garfield Heights, OH 44105-6922
Phone (216) 401-0652

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
I20210428003205 OH Practitioner - Clinical Social Worker 3577972777 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

2900 Presidential Dr
Suite 100
Beavercreek, OH 45324-6502
Phone (216) 468-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21824458OHMDSchool Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Apr 27, 2021 Accepting new patients
Psychological & Behavioral Consultants, LLC Clinical CurrentSince May 25, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

2900 Presidential Dr
Ste 100
Beavercreek, OH 45324
Phone (513) 741-3100

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

25111 Country Club Blvd
Ste 290
North Olmsted, OH 44070
Phone (440) 614-2520

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": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1407466287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630",
            "telephone_number": "216-468-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 PRESIDENTIAL DR STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "453246502",
            "telephone_number": "216-468-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13006 Maplerow Ave",
            "address_purpose": "LOCATION",
            "city": "Garfield Heights",
            "state": "OH",
            "postal_code": "441056922",
            "country_code": "US",
            "telephone_number": "216-401-0652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "MESHALLE",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "OH",
            "license": "21824458",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0010097-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

Verify at the official NPI Registry.