Individual provider Active NPI

Beth Ann Sommers-Souder, MSW, LISW-S

  • Clinical Social Worker
  • Mansfield, OH
National Provider Identifier
1578189908
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0500005-SUPV Issued in OH
Practice address
Richland Correctional Institute
1001 Olivesburg Road
Mansfield, OH 44905
Phone
(419) 526-2100
NPI assigned
Jun 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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.0500005-SUPV OH Primary

Addresses

Primary practice location

Richland Correctional Institute
1001 Olivesburg Road
Mansfield, OH 44905

Mailing address

Richland Correctional Institute
1001 Olivesburg Road
Mansfield, OH 44905
Phone (419) 526-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
I.0500005-SUPVOHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1578189908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RICHLAND CORRECTIONAL INSTITUTE",
            "address_2": "1001 OLIVESBURG ROAD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "44905",
            "telephone_number": "419-526-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RICHLAND CORRECTIONAL INSTITUTE",
            "address_2": "1001 OLIVESBURG ROAD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "44905",
            "telephone_number": "419-526-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMMERS-SOUDER",
        "first_name": "BETH",
        "middle_name": "ANN",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0500005-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.