Individual provider Active NPI

Tamara Marie Segrist, LSW

  • Clinical Social Worker
  • Napoleon, OH
National Provider Identifier
1417334319
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S1200045 Issued in OH
Practice address
600 Freedom Dr
Napoleon, OH 43545-9038
Phone
(419) 599-1660
Fax
(419) 592-8336
NPI assigned
Apr 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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 S1200045 OH Primary

Addresses

Primary practice location

600 Freedom Dr
Napoleon, OH 43545-9038

Mailing address

4880 County Road 10 2
Wauseon, OH 43567-9582
Phone (419) 599-1660

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S1200045OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1417334319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4880 COUNTY ROAD 10 2",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435679582",
            "telephone_number": "419-599-1660",
            "fax_number": "419-592-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FREEDOM DR",
            "city": "NAPOLEON",
            "state": "OH",
            "postal_code": "435459038",
            "telephone_number": "419-599-1660",
            "fax_number": "419-592-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGRIST",
        "first_name": "TAMARA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S1200045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Napoleon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.