Individual provider Active NPI

Jonathan R Bland, MSW, LISW-S

  • Clinical Social Worker
  • Warren, OH
National Provider Identifier
1477082113
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2102739-SUPV Issued in OH
Practice address
8577 E Market St
Warren, OH 44484-2345
Phone
(330) 856-6663
Fax
(330) 856-1581
NPI assigned
Jun 7, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S1700256 OH
Clinical Social Worker 1041C0700X I.2102739-SUPV OH Primary

Addresses

Primary practice location

8577 E Market St
Warren, OH 44484-2345

Mailing address

2980 Belmont Ave
Youngstown, OH 44505-1834
Phone (330) 759-0276

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
I20210402000755 OH Practitioner - Clinical Social Worker 7618384983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psy-Care, Inc.Group PAC ID 9335136795, 29 clinicians

Practice addresses (Care Compare)

8577 E Market St
Warren, OH 44484-2390
Phone (330) 856-6663

Merit-based Incentive Payment System (MIPS)

Final score
41.34 of 100Reported as group
Quality
20.12
Improvement activities
0
Cost
84.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.2102739-SUPVOHMDClinical Social Worker
S1700256OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psycare, Inc. CurrentSince Mar 29, 2021 Accepting new patients
Psy-Care Inc Clinical Current Accepting new patients
Psy Care Inc CurrentSince Mar 29, 2021 Accepting new patients

Locations

520 Youngstown Poland Rd
Struthers, OH 44471
Phone (330) 318-3078

8577 E Market St
Warren, OH 44484
Phone (330) 856-6663

2980 Belmont Ave
Youngstown, OH 44505
Phone (330) 759-0276

Organizations & group practices 3

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1477082113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051834",
            "telephone_number": "330-759-0276",
            "fax_number": "330-759-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8577 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842345",
            "telephone_number": "330-856-6663",
            "fax_number": "330-856-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAND",
        "first_name": "JONATHAN",
        "middle_name": "R",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S1700256",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2102739-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.