Individual provider Active NPI

Henry A Mazur, LISW CCDC IIIE

  • Social Worker
  • Pepper Pike, OH
National Provider Identifier
1487636528
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I0004140 Issued in OH
Practice address
28790 Chagrin Blvd
Suite 260
Pepper Pike, OH 44122-4642
Phone
(216) 839-2273
Fax
(216) 896-0735
NPI assigned
Nov 15, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I0004140 OH Primary

Addresses

Primary practice location

28790 Chagrin Blvd
Suite 260
Pepper Pike, OH 44122-4642

Mailing address

PO Box 24242
Cleveland, OH 44124-0242
Phone (216) 839-2273

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
I20140529002325 OH Practitioner - Clinical Social Worker 4082837596 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0004140OHMDSocial Worker

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, 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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1487636528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24242",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441240242",
            "telephone_number": "216-839-2273",
            "fax_number": "216-896-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28790 CHAGRIN BLVD",
            "address_2": "SUITE 260",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441224642",
            "telephone_number": "216-839-2273",
            "fax_number": "216-896-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUR",
        "first_name": "HENRY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LISW CCDC IIIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I0004140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pepper Pike, OH

Sources for this page

Verify at the official NPI Registry.