Individual provider Active NPI

Sherrill Michelle Dragovich, LISW

  • Social Worker
  • Columbus, OH
National Provider Identifier
1538423363
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S1101064 Issued in OH
Practice address
20 S 3Rd St Ste 210
Columbus, OH 43215-4206
Phone
(330) 322-9455
NPI assigned
Jun 26, 2012
Last updated
Jul 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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 S1101064 OH Primary

Addresses

Primary practice location

20 S 3Rd St Ste 210
Columbus, OH 43215-4206

Mailing address

9997 Rittman Rd
Wadsworth, OH 44281-9556
Phone (330) 322-9455

Other names 1

  • Sherrill Michelle Luketic Former name

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
I20230606002360 OH Practitioner - Clinical Social Worker 4981061934 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S1101064OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC CurrentSince May 3, 2023 Accepting new patients

Locations

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

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": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1538423363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9997 RITTMAN RD",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442819556",
            "telephone_number": "330-322-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S 3RD ST STE 210",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154206",
            "telephone_number": "330-322-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAGOVICH",
        "first_name": "SHERRILL",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S1101064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERRILL",
            "last_name": "LUKETIC",
            "middle_name": "MICHELLE",
            "credential": "MSW, LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.