Melissa Kathryn Van Dine

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2103322 Issued in OH

Practice address

1020 Woodman Dr Ste 330
Dayton, OH 45432-1410

Phone

(937) 253-0606

NPI assigned

Nov 8, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• National Youth Advocate Program, Inc

  • Community/Behavioral Health Agency
  • Canton, OH
  • NPI 1679721906
  Medicare reassignment NPD
• National Youth Advocate Program, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockford, IL
  • NPI 1841943495
  NPD

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1629581939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 WOODMAN DR STE 330",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454321410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 WOODMAN DR STE 330",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454321410",
            "telephone_number": "937-253-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DINE",
        "first_name": "MELISSA",
        "middle_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1802409",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2103322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vamc
• Carol Miller Van Ausdal, M.D.
• Jana Van Beckum
• Stacie Michelle Van Dam
• Kathryn P. Van Der Heiden, LPCC
• Kara Lenae Van Doesburg, COTA/L
• Lona M Van Hoose, STNA
• Sarah Marie Van Nostrand, D.O.
• Tyler Van Ry, DO
• David L. Van Winkle, PH.D.

• Clinical Social Worker in Dayton, OH
• Providers in Dayton, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.