Individual provider Active NPI

Breanna Scarberry, MSW. LISW

  • Clinical Social Worker
  • Bowling Green, OH
National Provider Identifier
1619483286
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2204052 Issued in OH
Practice address
1084 S Main St Ste a
Bowling Green, OH 43402-4740
Phone
(419) 352-4624
NPI assigned
Dec 19, 2017
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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.2204052 OH Primary

Addresses

Primary practice location

1084 S Main St Ste a
Bowling Green, OH 43402-4740

Mailing address

1084 S Main St Ste a
Bowling Green, OH 43402-4740

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
I20230913000355 OH Practitioner - Clinical Social Worker 4981068798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1425 Starr Ave
Toledo, OH 43605-2456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.2204052OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Unison Behavioral Health Group, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Unison Behavioral Health Group, Inc Past Accepting new patients

Locations

1084 S Main St
Ste A
Bowling Green, OH 43402
Phone (419) 352-4624

1425 Starr Ave
Toledo, OH 43605
Phone (419) 259-4506

544 E Woodruff Ave
Toledo, OH 43604
Phone (419) 242-9577

Organizations & group practices 2

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": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1619483286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 S MAIN ST STE A",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1084 S MAIN ST STE A",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024740",
            "telephone_number": "419-352-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCARBERRY",
        "first_name": "BREANNA",
        "credential": "MSW. LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2204052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

Verify at the official NPI Registry.