Andrea Dietsch, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1700233 Issued in OH

Practice address

3737 Lander Rd
Pepper Pike, OH 44124-5712

Phone

(419) 376-7217

NPI assigned

Oct 14, 2014

Last updated

Apr 5, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• National Youth Advocate Program, Inc

  • Community/Behavioral Health Agency
  • Canton, OH
  • NPI 1679721906
  Medicare reassignment NPD
• National Youth Advocate Program, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockford, IL
  • NPI 1841943495
  NPD

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1427452820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 LANDER RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 LANDER RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245712",
            "telephone_number": "419-376-7217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETSCH",
        "first_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-14",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S 1302931",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "OH",
            "license": "S 1302931",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina M Daugherty, LSW
• Gerry Davis, MA, LSW
• Lola Dejohn
• Dental & Cosmetic Solutions LLC
• Tarell Derry, LSW
• Eileen A. Dodson, LCDC
• Nicole Donofrio
• Emerson Lee Douglas, LISW
• Amelia Elizabeth Dubaniewicz, D.D.S.
• Allison Effron, MD

• Clinical Social Worker in Pepper Pike, OH
• Providers in Pepper Pike, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.