Individual provider Active NPI

Heather Marie Coughlin, LISW-S

  • Clinical Social Worker
  • Akron, OH
National Provider Identifier
1629533864
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17013 Issued in SC
Practice address
640 W Market St
Akron, OH 44303-1413
Phone
(330) 762-5425
NPI assigned
Feb 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.1600738 OH
Clinical Social Worker 1041C0700X 17013 SC Primary

Addresses

Primary practice location

640 W Market St
Akron, OH 44303-1413

Mailing address

640 W Market St
Akron, OH 44303-1413
Phone (330) 762-5425

Other names 1

  • Heather Marie Milano Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, SC, NC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200316002713 OH Practitioner - Clinical Social Worker 4082042585 Reassigns benefits to 1 organization
I20240911000394 SC Practitioner - Clinical Social Worker 4082042585
I20241108000461 NC Practitioner - Clinical Social Worker 4082042585

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blick Clinic, Inc.Group PAC ID 6709771843, 14 clinicians

Practice addresses (Care Compare)

274 White Pond Dr
Akron, OH 44320-1118
Phone (330) 762-5425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1600738OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifesource of North Carolina Clinical CurrentSince Aug 16, 2024 Accepting new patients
Lifesource of North Carolina Clinical CurrentSince Aug 16, 2024 Accepting new patients
Blick Clinic, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Lifesource of North Carolina Clinical CurrentSince Nov 11, 2024 Accepting new patients
Blick Clinic, Inc. CurrentSince Mar 1, 2020 Accepting new patients

Locations

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

2279 Romig Rd
Akron, OH 44320
Phone (330) 253-4597

640 W Market St
Akron, OH 44303
Phone (330) 762-5425

274 White Pond Dr
Akron, OH 44320
Phone (330) 762-5425

1915 Ebenezer Rd
Rock Hill, SC 29732
Phone (305) 866-9951

Organizations & group practices 5

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": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1629533864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 W MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443031413",
            "telephone_number": "330-762-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 W MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443031413",
            "telephone_number": "330-762-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHLIN",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600738",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "17013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "MILANO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.