Individual provider Active NPI

Emma Bogard, M.S.S.A., L.I.S.W.-S

  • Clinical Social Worker
  • University Heights, OH
National Provider Identifier
1578987053
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1600335-SUPV Issued in OH
Practice address
22001 Fairmount Blvd
University Heights, OH 44118-4819
Phone
(216) 320-8506
NPI assigned
Feb 5, 2014
Last updated
Feb 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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.1600335-SUPV OH Primary

Addresses

Primary practice location

22001 Fairmount Blvd
University Heights, OH 44118-4819

Mailing address

22001 Fairmount Blvd
University Heights, OH 44118-4819
Phone (216) 320-8506

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
I20190509001341 OH Practitioner - Clinical Social Worker 8123361318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8334 Tyler Blvd
Mentor, OH 44060-4221
Phone (440) 299-7854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1600335-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Counseling Solutions, LLC CurrentSince Apr 6, 2019 Accepting new patients

Locations

7547 Mentor Ave
Ste 310
Mentor, OH 44060
Phone (440) 299-7854

8334 Tyler Blvd
Mentor, OH 44060
Phone (440) 299-7854

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": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1578987053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-320-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22001 FAIRMOUNT BLVD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441184819",
            "telephone_number": "216-320-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGARD",
        "first_name": "EMMA",
        "credential": "M.S.S.A., L.I.S.W.-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-05",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600335-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Heights, OH

Sources for this page

Verify at the official NPI Registry.