Individual provider Active NPI

Deborah Doling-Dade

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1457784696
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I1303030 Issued in OH
Practice address
399 E Main St
Columbus, OH 43215-5384
Phone
(614) 355-8550
Fax
(614) 355-8593
NPI assigned
Aug 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 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 I1303030 OH Primary

Addresses

Primary practice location

399 E Main St
Columbus, OH 43215-5384

Mailing address

PO Box 715194
Columbus, OH 43271-5194
Phone (614) 355-8004

Other practice location 1

2318 E. Main Street
Suite 100
Lancaster, OH 43130
Phone (614) 362-0347

Other identifiers 2

IdentifierTypeStateIssuer
0210445MedicaidOH
2846675MedicaidOH

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
I20200507002905 OH Practitioner - Clinical Social Worker 1153752118 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I1303030OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
3D Pathways, LLC Clinical CurrentSince May 2, 2020 Accepting new patients

Locations

57 W Waterloo St
Ste 103
Canal Winchester, OH 43110
Phone (614) 321-4010

1209 Hill Rd N
Pickerington, OH 43147
Phone (614) 344-8488

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": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1457784696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 715194",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432715194",
            "telephone_number": "614-355-8004",
            "fax_number": "614-355-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155384",
            "telephone_number": "614-355-8550",
            "fax_number": "614-355-8593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2318 E. Main Street",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "OH",
            "postal_code": "43130",
            "country_code": "US",
            "telephone_number": "614-362-0347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLING-DADE",
        "first_name": "DEBORAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1303030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0210445",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.