Individual provider Active NPI

Stephanie Skavdahl, LISW-S

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1568946259
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
253845 Issued in KY
Practice address
6527 Colerain Ave
Cincinnati, OH 45239-5537
Phone
(513) 834-7063
Fax
(513) 873-1567
NPI assigned
Sep 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X I.1700752 OH
Counselor 101Y00000X 7422 KY
Social Worker 104100000X I.1700752 OH
Clinical Social Worker 1041C0700X 253845 KY Primary

Addresses

Primary practice location

6527 Colerain Ave
Cincinnati, OH 45239-5537

Mailing address

446 Morgan St
Cincinnati, OH 45206-2348
Phone (513) 834-7063

Other identifiers 1

IdentifierTypeStateIssuer
0364702MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7422KYMDCounselor
I.1700752OHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Medical Center Counselor CurrentSince Apr 13, 2023 Accepting new patients
Arnold G. Shapiro MD, PLLC PastSince Aug 1, 2014 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1568946259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 MORGAN ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452062348",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6527 COLERAIN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452395537",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKAVDAHL",
        "first_name": "STEPHANIE",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-19",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "I.1700752",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "KY",
            "license": "7422",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.1700752",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "253845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0364702",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.