Individual provider Active NPI

Marnie Lenore Willett, LISW-S

  • Clinical Social Worker
  • Canton, OH
National Provider Identifier
1508118480
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I 0700278 Issued in OH
Practice address
1341 Market Ave N
Canton, OH 44714-2605
Phone
(330) 453-8252
Fax
(330) 452-4655
NPI assigned
Oct 3, 2012
Last updated
Oct 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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 0700278 OH Primary

Addresses

Primary practice location

1341 Market Ave N
Canton, OH 44714-2605

Mailing address

1341 Market Ave N
Canton, OH 44714-2605
Phone (330) 453-8252

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
I20131004000270 OH Practitioner - Clinical Social Worker 0143454108 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I 0700278OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Village Network CurrentSince Mar 18, 2024 Accepting new patients

Locations

2000 Noble Dr
Wooster, OH 44691
Phone (330) 439-8492

2000 Noble Dr
Bldg I
Wooster, OH 44691

3011 Akron Rd
Wooster, OH 44691
Phone (330) 202-3809

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": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1508118480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 MARKET AVE N",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447142605",
            "telephone_number": "330-453-8252",
            "fax_number": "330-452-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 MARKET AVE N",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447142605",
            "telephone_number": "330-453-8252",
            "fax_number": "330-452-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLETT",
        "first_name": "MARNIE",
        "middle_name": "LENORE",
        "name_prefix": "Ms.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 0700278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.