Mariah Bainbridge, LSW
Individual provider Active NPI Social Worker · Toledo, OH
NPI 1619644747 · NPPES record last updated Nov 20, 2024
Key facts
- NPI
- 1619644747
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- S.2208477 (OH)
- Practice address
- 1425 Starr Ave
Toledo, OH 43605-2456 - Phone
- (419) 214-4673
- NPI assigned
- Aug 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.2208477 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Unison Behavioral Health Group, Inc | Past | Accepting new patients | |
| Unison Behavioral Health Group, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Social Worker | 104100000X | S.2208477 | OH | Yes |
Addresses
Primary practice location
1425 Starr Ave
Toledo, OH 43605-2456
Mailing address
1425 Starr Ave
Toledo, OH 43605-2456
Phone (419) 214-4673
Other practice location 1
349 W Main St.
Portage, OH 43451
Phone (419) 760-6037
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2615030 | Medicaid | OH | |
| 1619644747 | Medicaid | OH |
Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.