Individual provider Active NPI

Vernajean Eggleston, LISW-S

  • Clinical Social Worker
  • Marion, OH
National Provider Identifier
1619123023
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1199 Delaware Ave
Marion, OH 43302-6475
Phone
(440) 260-8300
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 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 Primary

Addresses

Primary practice location

1199 Delaware Ave
Marion, OH 43302-6475

Mailing address

434 Eastland Rd
Berea, OH 44017-1217
Phone (440) 234-2006

Other practice location 1

136 W Center St
Marion, OH 43302-3704
Phone (740) 751-6380

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
I20090120000367 OH Practitioner - Clinical Social Worker 5496818320 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0007360OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone CurrentSince Feb 17, 2020 Accepting new patients
Ohioguidestone CurrentSince Feb 17, 2020 Accepting new patients
Ohioguidestone Current Accepting new patients
Ohioguidestone Past Accepting new patients

Locations

434 Eastland Rd
Berea, OH 44017
Phone (440) 260-8327

202 E Bagley Rd
Berea, OH 44017
Phone (440) 260-8327

1199 Delaware Ave
Ste 107
Marion, OH 43302
Phone (740) 361-2258

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1619123023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171217",
            "telephone_number": "440-234-2006",
            "fax_number": "740-751-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 DELAWARE AVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026475",
            "telephone_number": "440-260-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 W Center St",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "OH",
            "postal_code": "433023704",
            "country_code": "US",
            "telephone_number": "740-751-6380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGGLESTON",
        "first_name": "VERNAJEAN",
        "name_prefix": "Mrs.",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.