Individual provider Active NPI

Jeffrey Halberg, LISW-S, LICDC-CS

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1467810713
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0800178 SUPV Issued in OH
Practice address
2440 Dawnlight Ave
Columbus, OH 43211-1934
Phone
(614) 416-8732
Fax
(614) 478-3294
NPI assigned
Feb 2, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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.0800178 SUPV OH Primary

Addresses

Primary practice location

2440 Dawnlight Ave
Columbus, OH 43211-1934

Mailing address

2440 Dawnlight Ave
Columbus, OH 43211-1934
Phone (614) 416-8732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0800178 SUPVOHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1467810713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 DAWNLIGHT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432111934",
            "telephone_number": "614-416-8732",
            "fax_number": "614-478-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 DAWNLIGHT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432111934",
            "telephone_number": "614-416-8732",
            "fax_number": "614-478-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALBERG",
        "first_name": "JEFFREY",
        "credential": "LISW-S, LICDC-CS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0800178 SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.