Individual provider Active NPI

Brooke Stuck

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1497171805
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1440092 Issued in OH
Practice address
1301 N High St
Columbus, OH 43201-2460
Phone
(614) 299-6600
NPI assigned
Mar 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X I.1440092 OH
Clinical Social Worker 1041C0700X I.1440092 OH Primary

Addresses

Primary practice location

1301 N High St
Columbus, OH 43201-2460

Mailing address

1301 N High St
Columbus, OH 43201-2460
Phone (614) 299-6600

Other identifiers 1

IdentifierTypeStateIssuer
1669437653MedicaidOH

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
I20221102001303 OH Practitioner - Clinical Social Worker 9830321264 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brave Health Medical Group, PAGroup PAC ID 9537586052, 93 clinicians

Practice addresses (Care Compare)

5178 Owl Creek Dr
Westerville, OH 43081-6637
Phone (305) 902-6347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Health Medical Group PA CurrentSince Apr 1, 2024 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Oct 20, 2022 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Nov 25, 2022 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

Interoperability endpoints

  • Direct secure messaging: brooke.stuck.1@23300.direct.athenahealth.com

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": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1497171805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012460",
            "telephone_number": "614-299-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432012460",
            "telephone_number": "614-299-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCK",
        "first_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "I.1440092",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1440092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669437653",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.