Active NPI
Larissa Sue Gerwig, LISW
- Clinical Social Worker
- Lorain, OH
National Provider Identifier
1609240555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.1800862
- Practice address
- 6140 S Broadway
Lorain, OH 44053-3821 - Phone
- (440) 233-7232
- NPI assigned
- Nov 16, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I.1800862 | OH | Primary |
Addresses
Primary practice location
6140 S Broadway
Lorain, OH 44053-3821
Mailing address
6140 S Broadway
Lorain, OH 44053-3891
Other practice location 1
22001 Fairmount Blvd
Shaker Hts, OH 44118
Phone (216) 932-2800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0267605 | Medicaid | OH |
Other names 1
- Larissa Sue Gerwig
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I.1800862 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Clinical | Current | Accepting new patients |
Interoperability endpoints
- larissagerwig@tdh.allscriptsdirect.net
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675382400000",
"number": "1609240555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6140 S BROADWAY",
"city": "LORAIN",
"state": "OH",
"postal_code": "440533891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6140 S BROADWAY",
"city": "LORAIN",
"state": "OH",
"postal_code": "440533821",
"telephone_number": "440-233-7232"
}
],
"practiceLocations": [
{
"address_1": "22001 Fairmount Blvd",
"address_purpose": "LOCATION",
"city": "Shaker Hts",
"state": "OH",
"postal_code": "44118",
"country_code": "US",
"telephone_number": "216-932-2800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GERWIG",
"first_name": "LARISSA",
"middle_name": "SUE",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-16",
"last_updated": "2023-02-03",
"certification_date": "2023-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.1800862",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0267605",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LARISSA",
"last_name": "GERWIG",
"middle_name": "SUE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lorain, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.