Individual provider Active NPI

Merissa Ann Durda, LISW-S

  • Clinical Social Worker
  • Beachwood, OH
National Provider Identifier
1598300352
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1302478-SUPV Issued in OH
Practice address
25700 Science Park Dr Ste 210
Beachwood, OH 44122-7328
Phone
(216) 450-1613
Fax
(216) 450-1614
NPI assigned
Nov 15, 2019
Last updated
Oct 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X I.1302478-SUPV OH
Clinical Social Worker 1041C0700X I.1302478-SUPV OH Primary

Addresses

Primary practice location

25700 Science Park Dr Ste 210
Beachwood, OH 44122-7328

Mailing address

PO Box 844020
Dallas, TX 75284-4020
Phone (216) 450-1613

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
I20220913002901 OH Practitioner - Clinical Social Worker 7012392921 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Health, Inc CurrentSince Jul 29, 2022 Accepting new patients
Advanced Recovery Concepts LLC Mental Health CurrentSince Sep 26, 2022 Accepting new patients
Signature Health, Inc. Mental Health Current Accepting new patients
Signature Health Inc CurrentSince Jul 29, 2022 Accepting new patients

Locations

25700 Science Park Dr
Ste 210
Beachwood, OH 44122
Phone (216) 452-1613

1730 W 25th St
Cleveland, OH 44113
Phone (216) 696-4300

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

29055 Clemens Rd
#A
Westlake, OH 44145

38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333

38882 Mentor Ave
Willoughby, OH 44094

Organizations & group practices 4

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": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1598300352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844020",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844020",
            "telephone_number": "216-450-1613",
            "fax_number": "216-450-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25700 SCIENCE PARK DR STE 210",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441227328",
            "telephone_number": "216-450-1613",
            "fax_number": "216-450-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURDA",
        "first_name": "MERISSA",
        "middle_name": "ANN",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I.1302478-SUPV",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1302478-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.