Individual provider Active NPI

Taylor Fyffe

  • Clinical Social Worker
  • Portsmouth, OH
National Provider Identifier
1548829906
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2204030 Issued in OH
Practice address
901 Washington St
Portsmouth, OH 45662-3944
Phone
(740) 354-7702
NPI assigned
Jun 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1903849 OH
Social Worker 104100000X S.1903849 OH
Clinical Social Worker 1041C0700X I.2204030 OH Primary

Addresses

Primary practice location

901 Washington St
Portsmouth, OH 45662-3944

Mailing address

PO Box 1507
Portsmouth, OH 45662-1507

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
I20230220000743 OH Practitioner - Clinical Social Worker 1658743745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Ohio Medical University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shawnee Mental Health Center IncGroup PAC ID 7012902075, 25 clinicians

Practice addresses (Care Compare)

901 Washington St
Portsmouth, OH 45662-3944
Phone (740) 354-7702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1903849OHMDMental Health Counselor
S.1903849OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Shawnee Mental Health Center, Inc. CurrentSince Nov 24, 2022 Accepting new patients
Shawnee Mental Health Center, Inc. CurrentSince Nov 24, 2022 Accepting new patients
Shawnee Mental Health Center Inc PastSince Apr 5, 2020 Accepting new patients
Shawnee Mental Health Center, Inc. Past Accepting new patients
Shawnee Mental Health Center, Inc. Past Accepting new patients
Shawnee Mental Health Center, Inc. Past Accepting new patients

Locations

225 Carlton Davidson Ln
Coal Grove, OH 45638
Phone (740) 354-7702

901 Washington St
Portsmouth, OH 45662
Phone (740) 354-7702

192 Chestnut Ridge Rd
West Union, OH 45693
Phone (937) 544-5581

Organizations & group practices 6

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": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1548829906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1507",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456621507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WASHINGTON ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623944",
            "telephone_number": "740-354-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FYFFE",
        "first_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "1903849",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1903849",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2204030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

Verify at the official NPI Registry.