Individual provider Active NPI

Marilyn Kay Inceoglu, LISW-S

  • Clinical Social Worker
  • Newark, OH
National Provider Identifier
1427363472
Registry record updated Aug 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I. 0009917 Issued in OH
Practice address
1616 W Church St
Suite a
Newark, OH 43055-1540
Phone
(740) 616-0779
NPI assigned
Aug 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2010

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. 0009917 OH Primary

Addresses

Primary practice location

1616 W Church St
Suite a
Newark, OH 43055-1540

Mailing address

1616 W Church St
Suite a
Newark, OH 43055-1540
Phone (740) 616-0779

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
I20121212000495 OH Practitioner - Clinical Social Worker 6507018850

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

60 Messimer Dr
Newark, OH 43055-3674

630 W Main St
Suite D
Newark, OH 43055-4181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I. 0009917OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Woodlands, Serving Central Ohio Inc. Clinical PastSince Jun 1, 2012 Accepting new patients
Equitas Health, Inc Past Accepting new patients

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": "1281830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281830400000",
    "number": "1427363472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 W CHURCH ST",
            "address_2": "SUITE A",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551540",
            "telephone_number": "740-616-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 W CHURCH ST",
            "address_2": "SUITE A",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551540",
            "telephone_number": "740-616-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INCEOGLU",
        "first_name": "MARILYN",
        "middle_name": "KAY",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-15",
        "last_updated": "2010-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I. 0009917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.