Individual provider Active NPI

Brian Stump, LISW

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1427512292
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1801327 Issued in OH
Practice address
7504 Perry St Unit 317661
Cincinnati, OH 45231-7527
Phone
(513) 403-1061
NPI assigned
Jan 25, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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.1801327 OH Primary

Addresses

Primary practice location

7504 Perry St Unit 317661
Cincinnati, OH 45231-7527

Mailing address

PO Box 317661
Cincinnati, OH 45231-7661

Other practice location 1

10999 Reed Hartman Highway
Suite 304D
Cincinnati, OH 45242-8300
Phone (513) 549-6463

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
I.1801327OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Wellness Counseling and Consulting, LLC Clinical CurrentSince Sep 1, 2019 Accepting new patients

Locations

10999 Reed Hartman Hwy
Ste 304D
Blue Ash, OH 45242
Phone (513) 549-6463

7504 Perry St
Unit 317661
Cincinnati, OH 45231
Phone (513) 403-1061

Organizations & group practices 1

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": "1548374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1427512292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 317661",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452317661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7504 PERRY ST UNIT 317661",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452317527",
            "telephone_number": "513-403-1061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10999 Reed Hartman Highway",
            "address_2": "Suite 304D",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452428300",
            "country_code": "US",
            "telephone_number": "513-549-6463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUMP",
        "first_name": "BRIAN",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-25",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1801327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.