Individual provider Active NPI

Nancy Elizabeth Tacina, LISW

  • Clinical Social Worker
  • Wooster, OH
National Provider Identifier
1467991505
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1700110 Issued in OH
Practice address
2285 Benden Dr
Wooster, OH 44691-2568
Phone
(330) 264-9029
Fax
(330) 263-7251
NPI assigned
Feb 22, 2017
Last updated
Feb 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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.1700110 OH Primary

Addresses

Primary practice location

2285 Benden Dr
Wooster, OH 44691-2568

Mailing address

2285 Benden Dr
Wooster, OH 44691-2568
Phone (330) 264-9029

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
I20170918001140 OH Practitioner - Clinical Social Worker 0648544429 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Charities CorporationGroup PAC ID 6608866546, 12 clinicians

Practice addresses (Care Compare)

140 Richmond Rd
Euclid, OH 44143-1239
Phone (800) 860-7373

6753 State Rd
Parma, OH 44134-4517
Phone (800) 860-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1700110OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities Corporation Current Accepting new patients

Locations

1515 W 29th St
Cleveland, OH 44113
Phone (216) 574-9000

7911 Detroit Ave
Cleveland, OH 44102
Phone (216) 334-2876

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1467991505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 BENDEN DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912568",
            "telephone_number": "330-264-9029",
            "fax_number": "330-263-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 BENDEN DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912568",
            "telephone_number": "330-264-9029",
            "fax_number": "330-263-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACINA",
        "first_name": "NANCY",
        "middle_name": "ELIZABETH",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.